Virtual motor training to improve the activities of daily living, hand grip, and gross motor function among children with cerebral palsy: Meta-regression analysis

Given that cerebral palsy is a lifelong condition, continuous motor training is necessary to correct abnormal posture and patterns to improve functional performance.To explore the essential features of virtual motor training and identify its effects on the activities of daily living, hand grip function, and gross motor function among children with cerebral palsy.Ten databases were systematically searched for randomized controlled trials from inception until October 15, 2019. Studies with a randomized controlled trials design, children with cerebral palsy, comparisons of virtual motor training with other interventions, and activities of daily living, hand grip, and gross motor function outcomes were included. Subgroup analyses and meta-regression were performed. The effect size was assessed using random-effects meta-analysis and evaluated by using Hedges' g. Random effects univariate meta-regression model was used to examine the association of covariates with intervention effectiveness.Seventeen randomized controlled trials with 853 participants were included. Meta-analysis indicated that the virtual motor training had significant positive effects on activities of daily living (g = 0.31, 95% confidence interval, CI = 0.10, 0.51), grip (g = 0.40, 95% CI = 0.08, 0.71), and gross motor (g = 0.71, 95% CI = 0.43, 0.99) function. Univariate random-effects meta-regression analysis indicated an increase in activities of daily living scores for motion capture systems that used depth imaging compared with those that used digital imaging.Our systematic review indicated that virtual motor function may significantly improve ADLs, hand grip, and gross motor functions among children with cerebral palsy.