The use of robotic rehabilitation in the treatment of motor impairments in children with cerebral palsy – a systematic review and meta-analysis

Abstract

Cerebral palsy is a neurological disorder affecting motor function in children with cerebralpalsy and requires new rehabilitation perspective beyond traditional pediatric treatments.Robotic-assisted gait training and other assistive devices as methods of robotic rehabilitationbecame popular as a way to improve motor function in pediatric patients with cerebral palsy.This meta-analysis evaluated the effectiveness of robotic rehabilitation on motor impairmentsin children with cerebral palsy, focusing on functional outcomes like gait, balance and grossmotor skills. PubMed, Embase, Cochrane Library, Scopus and Web of Science databaseswere searched and research papers were included up to 2024. Studies with roboticinterventions for children with cerebral palsy were included using the PICOS criteria. Theprimary outcome was to evaluate the improvement in motor function by measuring grossmotor skills and gait parameters. Data analysis used effect size calculation, I² statistic forheterogeneity, Egger test and funnel plot analysis for publication bias, as well as metaregression analysis. This review included 56 research papers. Robotic-assisted rehabilitationshowed improvements in motor skills, walking speed, balance and functional mobility withrobotic-assisted gait training being the most effective. Moderate heterogeneity was I²=52%and no publication bias was found through this review. Robotic rehabilitation with focus onrobotic-assisted gait training is showing improvements in motor function for children withcerebral palsy and has many advantages over traditional rehabilitation methods by allowingcontrolled repetitive training. Future research should focus on continuous outcomes andoptimization protocols to assure that robotic-assisted rehabilitation is relevant to the field ofpediatric neurorehabilitation.