{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:45:28Z","timestamp":1781739928677,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upper extremity impairments in children with cerebral palsy (CP) often lead to activity limitation and participation restrictions. Recent advances in exoskeleton technology offer promising potential for enhancing rehabilitation outcomes. This systematic review investigates the impact of upper extremity exoskeletons on children with CP using the International Classification of Functioning, Disability and Health (ICF) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, five electronic databases were searched without time limitations (PROSPERO ID: CRD42021282377). Studies included randomized and non\u2010randomized trials, focusing on upper extremity exoskeleton interventions for children with CP and published in English. Data were screened and extracted by two independent reviewers. The risk of bias was evaluated using the Revised Cochrane Risk of Bias Tool and the Risk of Bias in Non\u2010Randomized Studies of Interventions for randomized and non\u2010randomized studies, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A review of 22 studies involving 274 participants assessed the effectiveness of upper extremity exoskeletons on children with CP across different ICF domains. The studies employed various designs, including randomized controlled trials, cohort studies and case series, with a primary emphasis on body functions and structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While advancements in body function and structure are noteworthy, they do not inherently lead to improved activity and participation, highlighting the importance of conducting further research to evaluate the effectiveness of exoskeletons, particularly in enhancing participation outcomes among children with CP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.70163","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T08:15:40Z","timestamp":1759824940000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of Upper Extremity Exoskeletons in Children With Cerebral Palsy Within International Classification of Functioning, Disability and Health Domains: A Systematic Review"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0114-7923","authenticated-orcid":false,"given":"Ghodsiyeh","family":"Joveini","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy, School of Rehabilitation Sciences Kermanshah University of Medical Sciences  Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Boozari","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Medical Sciences Tarbiat Modares University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6983-0569","authenticated-orcid":false,"given":"Armin","family":"Zareiyan","sequence":"additional","affiliation":[{"name":"Department of Public Health AJA University of Medical Sciences  Tehran Iran"},{"name":"Department of Health in Disasters and Emergencies AJA University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9732-5498","authenticated-orcid":false,"given":"Mahnaz","family":"Hejazi\u2010Shirmard","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, School of Rehabilitation Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Stergiou","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport Science Aristotle University  Thessaloniki Greece"},{"name":"Department of Biomechanics and Center for Research in Human Movement Variability, Division of Biomechanics and Research Development University of Nebraska at Omaha  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162201002134"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1537170"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000537"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.24075\/brsmu.2020.047"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252193"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-83655-8_1"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/17518423.2014.899648"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2016.1145258"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10882\u2010018\u20109632\u2010y"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/JPO.0000000000000330"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/23822"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207454.2018.1536051"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2011.631678"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000852"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31818a6aa4"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3233\/TAD\u20102010\u20100303"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/17518423.2010.501362"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968314541172"},{"key":"e_1_2_12_21_1","unstructured":"Group O. 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