Effectiveness of robotic rehabilitation interventions in children with cerebral palsy: protocol for a systematic review and meta-analysis of randomized controlled trials.

Abstract

<h4>Background</h4>Cerebral palsy (CP) is the leading cause of childhood motor disability, often requiring intensive, long-term rehabilitation to improve motor function and independence in daily activities. Robot-assisted therapy has emerged as a promising intervention, as it can deliver high-intensity, task-specific, and motivating treatment. However, evidence for its superiority over conventional rehabilitation interventions (CRIs) is inconsistent, and a comprehensive quantitative synthesis is lacking. This protocol details a systematic review and meta-analysis to evaluate the effectiveness of robot-assisted therapy on motor outcomes in children with CP.<h4>Methods</h4>This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. We will conduct a comprehensive search of five electronic databases (PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library) from their inception to June 2025. The review will include randomized controlled trials (RCTs) comparing robot-assisted therapy with CRIs in children with CP. Two independent reviewers will screen titles, abstracts, and full texts and extract relevant data. Primary outcomes will include measures of gross motor function, activities of daily living (ADL), gait, and balance. Secondary outcomes will include upper limb function and quality of life. Where appropriate, we will perform a meta-analysis using a random-effects model in Stata 14.0. We will investigate sources of heterogeneity using subgroup and sensitivity analyses. Publication bias will be assessed with funnel plots and Egger's test. Furthermore, Trial Sequential Analysis will be employed to assess the robustness of the findings and control for risks of random error. The overall quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.<h4>Systematic review registration</h4>PROSPERO CRD420250652267.