Effectiveness of training with motion-controlled commercial video games on hand and arm function in young people with cerebral palsy: A systematic review and meta-analysis.

To examine the effect of motion-controlled commercial video games compared with traditional occupational and physiotherapy methods for hand and arm function in persons of all ages with cerebral palsy. A systematic literature search was conducted in Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, OTseeker and PEDro for randomized controlled trials involving persons with cerebral palsy using motion-controlled commercial video games as a training method for hand and arm function, compared with traditional therapy. Screening, data-extraction, risk of bias and quality assessment was carried out independently by 2 of the authors. The risk of bias of each study was assessed using the Cochrane Collaborations Risk of Bias Tool. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Eight randomized controlled trials, with a total of 262 participants, were included. A random effects meta-analysis showed a statistically significant difference between the groups in favour of motion-controlled commercial video games. The quality of the evidence was, however, rated as very low. Despite a significantly greater improvement in hand and arm function in favour of motion-controlled commercial video games, the results of this review should be interpreted with caution with regards to high risk of bias and the low strength of evidence. There is a need for high-powered studies on the effectiveness of training with motion-controlled commercial video games for persons with cerebral palsy, especially in adults.