Strengths and limitations
To our knowledge, this is the first RCT that has tested the non-inferiority of a virtual-based session substituting for nearly one half of the one-on-one therapeutic time in an evidence-based intervention for motor function of the upper and lower extremities in children with CP. Furthermore, as previously recommended, this study documented the therapeutic content and active ingredients of the virtual-based intervention [Due to limited availability of instrumentation, we had the opportunity to measure accelerometer data on each child for only one therapeutic day. Although the accelerometry results could have shown modifications with a whole-camp monitoring, we assume the results would not be likely to differ based on the obtained results, as well as for the comparison between both groups. Moreover, accelerometers quantify the acceleration of the limb, without differentiation of the type of movement (therapeutically useful or not), nor do they capture fingers/hand fine motoric movements. Measures of activity duration and counts were of interest to document movement intensity and duration, but might not suffice to determine whether movements were indeed task-based activities. Despite its concrete feasibility being questionable, an additional control based on a synchronized video recording could have been carried out to validate whether the measured accelerations indeed corresponded to task-based activities movements.