The Effects of Neuromuscular Electrical Stimulation and Leap Motion-Based Exercises on Hand Function Parameters in Children With Cerebral Palsy: Study Protocol for a Randomized Controlled Trial.

Background: Cerebral palsy (CP) is a group of permanent but nonprogressive disorders that affect movement and posture, often accompanied by upper extremity impairments such as abnormal muscle tone, spasticity, weakness, and impaired motor control. Neuromuscular electrical stimulation (NMES) and Leap Motion-based interventions that promote neuroplasticity through different mechanisms. However, studies directly comparing these 2 approaches in children with spastic CP are limited. Objective: This study primarily aims to investigate the effects of NMES and Leap Motion-based exercise interventions on hand function in children with spastic CP and to compare the effectiveness of these 2 modalities. The secondary objective is to evaluate and compare the effects of these interventions on wrist extensor muscle activation, wrist joint range of motion, selective motor control, and hand use in daily activities. Methods: This study is a 2-arm, parallel-group randomized controlled trial with a 1:1 allocation ratio and will include 30 children aged 6-15 years with spastic CP and distal upper extremity involvement. All participants meeting the inclusion criteria will undergo baseline assessments at T0, where wrist range of motion will be measured using an electronic goniometer; selective motor control will be evaluated using the Selective Control of the Upper Extremity Scale (SCUES); hand function will be assessed using the Jebsen-Taylor Hand Function Test; daily hand use will be evaluated using the ABILHAND-Kids questionnaire; and wrist extensor and flexor muscle activation will be assessed using surface electromyography (sEMG). All participants will then undergo a 4-week conventional exercise program (3 sessions per week, 40 minutes per session). At the end of the 4 weeks, all baseline measurements will be repeated (T1). Subsequently, participants will be randomly assigned into 2 groups: the Leap Motion group (n=15) and the NMES group (n=15). Both groups will participate in an 8-week exercise program consisting of 3 sessions per week, 60 minutes per session (including 20 minutes of either Leap Motion-based exercise or NMES application, followed by 40 minutes of conventional exercise). At the end of this 8-week program, all assessments will be repeated (T2). Results: Data collection started in January 2026. The study is expected to be completed by September 2026. Conclusions: To our knowledge, the study will be the first randomized controlled study to evaluate and compare the effects of NMES and Leap Motion-based training on hand functions in children with spastic CP. The findings are expected to contribute to evidence-based clinical practice by guiding the selection of effective upper extremity rehabilitation strategies for pediatric populations. Findings may inform future rehabilitation protocols by highlighting the benefits of integrating advanced technology-based interventions alongside conventional therapy approaches.