Virtual reality in motor rehabilitation for children with cerebral palsy: review of neurophysiological effects.

Abstract

Cerebral palsy affects movement and posture, resulting in multisystem impairments that limit functional independence and participation. Physical therapy plays a significant role in addressing these challenges, and virtual reality (VR) has emerged as a promising modality to improve motor control and support neuroplasticity. This systematic review aimed to determine the impact of virtual reality-based physical therapy interventions on motor function, gait, balance, and neuroplasticity mechanisms in children with cerebral palsy. Following PRISMA guidelines, nine studies were identified, critically appraised, and synthesized using a qualitative narrative approach. Virtual reality (VR)–based rehabilitation has emerged as an effective and engaging therapeutic modality for children with cerebral palsy. Evidence across diverse intervention formats demonstrates consistent improvements in upper-limb function, balance, gait performance, and overall motor abilities. Immersive and sensory-enriched VR systems enhance engagement, proprioceptive feedback, and sensorimotor integration. Although neurophysiological outcomes remain insufficiently investigated, preliminary findings suggest that multimodal VR, alone or combined with neuromodulation, may support neuroplasticity. Current evidence positions VR as a valuable adjunct to conventional pediatric therapy. Future research should prioritize standardized protocols, integration of neurophysiological measures, and large-scale randomized controlled trials to optimize clinical application.