## 1 Introduction
While these positive results are promising, the heterogeneity of neural disorders raises concerns, limiting the ability to draw definitive conclusions and provide clear clinical guidance [31]. CP is characterized by a wide variety of risk factors, underlying causes, clinical features, and severity of functional impairments, often accompanied by secondary conditions and varying treatment options over time [32; 33; 34]. Nintendo Wii therapy (NWT) is one of the most widely used non-immersive virtual reality devices in the neurorehabilitation of children with CP that requires active participation and movement. The Nintendo Wii allows participants to interact with a virtual environment projected on a screen using a handled controller or joystick with or without a force platform called the Wii Balance Board [35; 36; 34]. Findings suggest that the Nintendo Wii, particularly the Wii-Fit Balance Board, can be a valuable tool in rehabilitation programs for improving balance, motor function, and functional mobility in children with cerebral palsy [35; 36; 37; 38; 39]. For example, [PERSON] et al. (2017) demonstrated that a Nintendo Wii Balance Board exercise program significantly improved standing balance in children with spastic hemip-gia cerebral palsy, though effects diminished 2-4 weeks post-intervention [37]. [PERSON] and [PERSON] (2017) found moderate evidence that integrating the Nintendo Wii-Fit Balance Board into exercise programs enhances balance in ambulatory children with cerebral palsy, particularly dynamic balance, with greater improvements requiring frequent sessions over six weeks [38]. [PERSON] and [PERSON] (2024) demonstrated that combining Wii-Fit exercises with conventional therapy significantly improved static balance, functional mobility, and walking endurance in children with cerebral palsy and their typically developing peers over a 16-week program [39]. [PERSON] et al. (2016) investigated the impact of a Nintendo Wii Balance Board exercise program on functional balance in Latino male outpatients with cerebral palsy, showing significant improvements in dynamic balance but no changes in static balance after 6 weeks [36]. A pilot study conducted in Jamaica explored the potential of using the Nintendo Wii as a rehabilitation tool for children with cerebral palsy, showing improvements in gross motor function and high attendance and engagement, suggesting its feasibility for use in rehabilitation [40]. To our knowledge, gross motor performance measures to evaluate the quality of movement following the use of the Nintendo Wii Balance Board-based intervention for standing activities in children with cerebral palsy have either not been used or have seen limited application. Building on previous research, this study aims to evaluate whether incorporating a VR-based Nintendo Wii Balance Board exercise program into the standard treatment regimen for children with CP in Greece can improve balance, gross motor function, and performance in standing activities. A single-case experimental design will be used to assess individual-level outcomes. The research questions guiding this study are as follows:  
Does the use of the Nintendo Wii Balance Board-based intervention in standing game activities provide an additional therapeutic effect on balance, gross motor function, and quality of movement in children with CP? Can VR and motion-based systems, such as the Wii Balance Board, be feasibly applied to enhance physical rehabilitation outcomes for children with cerebral palsy, considering the challenges and cultural context in Greece? This paper is organized into four main sections. Section 1 introduces the purpose and significance of the study, providing the research context and objectives. Section 2 outlines the materials and methods, including the study design, participant criteria, intervention details, and outcome measures. Section 3 presents the results obtained through statistical analysis, focusing on improvements in gross motor function, balance, and motor performance.