A Two-Step Neurorehabilitation Program Utilizing Extended Reality and Telerehabilitation for Children with Cerebral Palsy: A Pilot Study on Effectiveness, Adherence, and Technical Feasibility

In recent years, extended reality (XR) and telerehabilitation (TR) technologies have increasingly been used in the neurorehabilitation of motor dysfunctions in patients with cerebral palsy (CP). The Khymeia Virtual Reality Rehabilitation System (K-VRRS) is a medical device specifically designed for neuromotor rehabilitation, and it can also be used in TR mode. This pilot study aims to evaluate the effectiveness and adherence to a “two-step neuromotor program” (TS-NP) approach using K-VRRS to enhance upper limb motor functions in children with CP. The TS-NP protocol consists of two phases. In the first phase, patients undergo intensive motor training with K-VRRS during a period of hospitalization. In the second phase, initiated after discharge, patients continue K-VRRS treatment at home through TR, building upon the progress made during their hospital stay. A total of seven children with unilateral spastic CP (ages 4–10 years) were assessed at three time points: baseline (T0), after the first phase of in-person hospital treatment (T1), and following the second phase of TR treatment at home (T2). Standardized outcome measures were used, with the primary measure being the Melbourne Assessment 2. Preliminary data support the hypothesis that intensive K-VRRS treatment during hospitalization enhances motor function in the affected upper limb of children with CP. Furthermore, continuing K-VRRS treatment at home through TR appears crucial for maintaining the motor gains achieved during the hospital phase.