500 Section - The efficacy of robot-assisted therapy on upper limb motor function in children with cerebral palsy: a systematic review and meta-analysis

Cerebral palsy (CP) is the leading cause of neurodevelopmental motor disability in children, often resulting in impaired upper limb function. Although traditional interventions offer benefits, they are limited by therapist dependence and poor adherence. Robot-assisted therapy (RAT) has emerged as a promising alternative, providing repetitive and high-intensity training. However, its clinical efficacy, particularly for upper limb rehabilitation in CP, remains inconclusive.


Design:

A systematic search was performed in eight electronic databases up to June 2025. Seven randomized controlled trials (RCTs) involving 244 children with CP met the inclusion criteria. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Data were synthesized using both fixed-effects and random-effects models, with effect sizes expressed as standardized mean differences (SMD) and 95% confidence intervals (CI).


Results:

RAT significantly improved fine motor function (SMD = 0.85, 95% CI: 0.40–1.30, P = 0.0002) and participation in daily activities (SMD = 0.69, 95% CI: 0.25–1.14, P = 0.002). No significant improvements were found in muscle strength (SMD = 0.21, P = 0.31) or gross motor function (SMD = 0.89, P = 0.23).


Conclusion:

RAT significantly improves fine motor function and daily activity participation in children with CP, but evidence on muscle strength and gross motor function remains inconclusive. Larger, high-quality studies with standardized protocols are needed to confirm these findings.