Abstract. – OBJECTIVE: The long-term con￾sequences of congenital diaphragmatic hernia (CDH), which include altered lung functions and compromised cardiopulmonary capacity, impact functional performance and quality of life. This study investigates the effects of virtual reali￾ty-based exercise programs on pulmonary func￾tions, cardiopulmonary capacity, functional per￾formance, and quality of life in children with re￾paired CDH. PATIENTS AND METHODS: A randomized controlled clinical trial was performed. Fifty-two children with repaired CDH (aged 6-10 years) were enrolled and randomly allocated to virtu￾al reality-based exercises plus traditional phys￾ical therapy (VR-EX group, n = 26) or tradition￾al physical therapy alone (control group, n = 26). Interventions were conducted three times a week for 12 weeks. Pulmonary functions, car￾diopulmonary capacity, functional performance, and quality of life were assessed before and af￾ter the intervention.RESULTS: The VR-EX group demonstrated significantly enhanced post-treatment pulmo￾nary functions and cardiopulmonary capacity compared to the control group after account￾ing for the pre-treatment values (p < 0.05). In addition, the values in functional performance and quality of life measures showed signifi￾cantly larger improvements in the VR-EX group (p < 0.05). CONCLUSIONS: Children with repaired CDH may benefit more from VR-based exercises when combined with traditional physical thera￾py than from traditional physical therapy alone regarding their pulmonary functions, cardiopul￾monary capacity, functional performance, and quality of life.