{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T12:10:52Z","timestamp":1775650252557,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Syst Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO CRD420250652267.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13643-026-03139-4","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:46:23Z","timestamp":1772498783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of robotic rehabilitation interventions in children with cerebral palsy: protocol for a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1186","volume":"15","author":[{"given":"Wei","family":"You","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kejimu","family":"Sunzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quanmin","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-515X","authenticated-orcid":false,"given":"Cheng","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"3139_CR1","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1111\/j.1469-8749.2000.tb00695.x","volume":"42","author":"C Cans","year":"2000","unstructured":"Cans C. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000;42:816\u201324.","journal-title":"Dev Med Child Neurol"},{"key":"3139_CR2","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.gaitpost.2022.09.082","volume":"98","author":"M Hunt","year":"2022","unstructured":"Hunt M, Everaert L, Brown M, Muraru L, Hatzidimitriadou E, Desloovere K. Effectiveness of robotic exoskeletons for improving gait in children with cerebral palsy: a systematic review. Gait Posture. 2022;98:343\u201354. https:\/\/doi.org\/10.1016\/j.gaitpost.2022.09.082.","journal-title":"Gait Posture"},{"issue":"6","key":"3139_CR3","first-page":"e1561","volume":"130","author":"I Novak","year":"2012","unstructured":"Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. 2012;130(6):e1561\u201370.","journal-title":"Pediatrics"},{"issue":"9","key":"3139_CR4","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1001\/jamapediatrics.2017.1689","volume":"171","author":"I Novak","year":"2017","unstructured":"Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897\u2013907. https:\/\/doi.org\/10.1001\/jamapediatrics.2017.1689.","journal-title":"JAMA Pediatr"},{"issue":"9","key":"3139_CR5","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1111\/dmcn.13708","volume":"60","author":"ATC Booth","year":"2018","unstructured":"Booth ATC, Buizer AI, Meyns P, Oude Lansink ILB, Steenbrink F, van der Krogt MM. The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2018;60(9):866\u201383. https:\/\/doi.org\/10.1111\/dmcn.13708.","journal-title":"Dev Med Child Neurol"},{"issue":"12","key":"3139_CR6","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.2522\/ptj.20150401","volume":"96","author":"NG Moreau","year":"2016","unstructured":"Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K. Effectiveness of rehabilitation interventions to improve gait speed in children with cerebral palsy: systematic review and meta-analysis. Phys Ther. 2016;96(12):1938\u201354.","journal-title":"Phys Ther"},{"issue":"9","key":"3139_CR7","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1080\/09638280400018437","volume":"27","author":"R Schenker","year":"2005","unstructured":"Schenker R, Coster W, Parush S. Participation and activity performance of students with cerebral palsy within the school environment. Disabil Rehabil. 2005;27(9):539\u201352.","journal-title":"Disabil Rehabil"},{"issue":"5","key":"3139_CR8","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/j.1469-8749.2002.tb00816.x","volume":"44","author":"E Beckung","year":"2002","unstructured":"Beckung E, Hagberg G. Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol. 2002;44(5):309\u201316.","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"3139_CR9","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s11910-007-0010-x","volume":"7","author":"MA Garvey","year":"2007","unstructured":"Garvey MA, Giannetti ML, Alter KE, Lum PS. Cerebral palsy: new approaches to therapy. Curr Neurol Neurosci Rep. 2007;7(2):147\u201355. https:\/\/doi.org\/10.1007\/s11910-007-0010-x.","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"10","key":"3139_CR10","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1111\/dmcn.12246","volume":"55","author":"I Novak","year":"2013","unstructured":"Novak I, McIntyre S, Morgan C, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885\u2013910. https:\/\/doi.org\/10.1111\/dmcn.12246.","journal-title":"Dev Med Child Neurol"},{"issue":"1","key":"3139_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00390-3","volume":"13","author":"M Hill","year":"2020","unstructured":"Hill M, Healy A, Chockalingam N. Effectiveness of therapeutic footwear for children: a systematic review. J Foot Ankle Res. 2020;13(1):23. https:\/\/doi.org\/10.1186\/s13047-020-00390-3.","journal-title":"J Foot Ankle Res"},{"issue":"8","key":"3139_CR12","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1177\/0883073811431011","volume":"27","author":"Y Hsin","year":"2012","unstructured":"Hsin Y, Chen F, Lin K, Kang L, Chen C, Chen C. Efficacy of constraint-induced therapy on functional performance and health-related quality of life for children with cerebral palsy. J Child Neurol. 2012;27(8):992\u20139. https:\/\/doi.org\/10.1177\/0883073811431011.","journal-title":"J Child Neurol"},{"issue":"7","key":"3139_CR13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.22625","volume":"7","author":"JY Choi","year":"2024","unstructured":"Choi JY, Kim SK, Hong J, et al. Overground gait training with a wearable robot in children with cerebral palsy: a randomized clinical trial. JAMA Netw Open. 2024;7(7):e2422625. https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.22625.","journal-title":"JAMA Netw Open"},{"key":"3139_CR14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.gaitpost.2017.11.007","volume":"60","author":"L Wallard","year":"2018","unstructured":"Wallard L, Dietrich G, Kerlirzin Y, Bredin J. Effect of robotic-assisted gait rehabilitation on dynamic equilibrium control in the gait of children with cerebral palsy. Gait Posture. 2018;60:55\u201360. https:\/\/doi.org\/10.1016\/j.gaitpost.2017.11.007.","journal-title":"Gait Posture"},{"issue":"3","key":"3139_CR15","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1111\/j.1469-8749.1989.tb04003.x","volume":"31","author":"DJ Russell","year":"1989","unstructured":"Russell DJ, Rosenbaum P, Cadman DT, Gowland C, Hardy S, Jarvis S. The gross motor function measure. Dev Med Child Neurol. 1989;31(3):341\u201352.","journal-title":"Dev Med Child Neurol"},{"issue":"24","key":"3139_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/s22249910","volume":"22","author":"I Cort\u00e9s-P\u00e9rez","year":"2022","unstructured":"Cort\u00e9s-P\u00e9rez I, Gonz\u00e1lez-Gonz\u00e1lez N, Peinado-Rubia AB, Nieto-Escamez FA, Obrero-Gait\u00e1n E, Garc\u00eda-L\u00f3pez H. Efficacy of robot-assisted gait therapy compared to conventional therapy or treadmill training in children with cerebral palsy: a systematic review with meta-analysis. Sensors. 2022;22(24):9910. https:\/\/doi.org\/10.3390\/s22249910.","journal-title":"Sensors"},{"issue":"7","key":"3139_CR17","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1177\/02692155221087084","volume":"36","author":"BC Conner","year":"2022","unstructured":"Conner BC, Remec NM, Lerner ZF. Is robotic gait training effective for individuals with cerebral palsy? A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2022;36(7):873\u201382. https:\/\/doi.org\/10.1177\/02692155221087084.","journal-title":"Clin Rehabil"},{"issue":"4","key":"3139_CR18","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1177\/10538135241296010","volume":"55","author":"A Martino Cinnera","year":"2024","unstructured":"Martino Cinnera A, Ciancarelli I, Paolucci T, et al. Evaluation of the effectiveness of Lokomat\u00ae robot-assisted gait training in children with cerebral palsy: a systematic review. NeuroRehabilitation. 2024;55(4):428\u201339.","journal-title":"NeuroRehabilitation"},{"issue":"1","key":"3139_CR19","doi-asserted-by":"publisher","first-page":"e175","DOI":"10.1542\/peds.2013-0675","volume":"133","author":"L Sakzewski","year":"2014","unstructured":"Sakzewski L, Ziviani J, Boyd RN. Efficacy of upper limb therapies for unilateral cerebral palsy: a meta-analysis. Pediatrics. 2014;133(1):e175\u2013204. https:\/\/doi.org\/10.1542\/peds.2013-0675.","journal-title":"Pediatrics"},{"issue":"1","key":"3139_CR20","doi-asserted-by":"publisher","first-page":"52","DOI":"10.22141\/2224-0713.21.1.2025.1150","volume":"21","author":"OO Kachmar","year":"2025","unstructured":"Kachmar OO, Kozyavkina NV, Kushnir AD, et al. Neuroplasticity in rehabilitation of children with cerebral palsy[J]. INTERNATIONAL NEUROLOGICAL JOURNAL. 2025;21(1):52\u20139.","journal-title":"INTERNATIONAL NEUROLOGICAL JOURNAL"},{"issue":"24","key":"3139_CR21","doi-asserted-by":"publisher","DOI":"10.3390\/s22249946","volume":"22","author":"F Moll","year":"2022","unstructured":"Moll F, Kessel A, Bonetto A, et al. Use of robot-assisted gait training in pediatric patients with cerebral palsy in an inpatient setting-a randomized controlled trial. Sensors. 2022;22(24):9946. https:\/\/doi.org\/10.3390\/s22249946.","journal-title":"Sensors"},{"key":"3139_CR22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https:\/\/doi.org\/10.1136\/bmj.n71.","journal-title":"BMJ"},{"issue":"2","key":"3139_CR23","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1111\/inm.12375","volume":"27","author":"A Badnapurkar","year":"2018","unstructured":"Badnapurkar A, Bressington D, Jones M, et al. Perception of nurse prescribing among nurses and psychiatrists in a developing country: a cross-sectional survey. Int J Ment Health Nurs. 2018;27(2):866\u201376. https:\/\/doi.org\/10.1111\/inm.12375.","journal-title":"Int J Ment Health Nurs"},{"issue":"1-2","key":"3139_CR24","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1177\/1527154418797726","volume":"19","author":"E Ladd","year":"2018","unstructured":"Ladd E, Schober M. Nurse prescribing from the global vantage point: the intersection between role and policy. Policy Polit Nurs Pract. 2018;19(1\u20132):40\u20139. https:\/\/doi.org\/10.1177\/1527154418797726.","journal-title":"Policy Polit Nurs Pract"},{"issue":"1","key":"3139_CR25","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1","volume":"4","author":"D Moher","year":"2015","unstructured":"Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. https:\/\/doi.org\/10.1186\/2046-4053-4-1.","journal-title":"Syst Rev"},{"issue":"9","key":"3139_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19095116","volume":"19","author":"R Llamas-Ramos","year":"2022","unstructured":"Llamas-Ramos R, S\u00e1nchez-Gonz\u00e1lez JL, Llamas-Ramos I. Robotic systems for the physiotherapy treatment of children with cerebral palsy: a systematic review. Int J Environ Res Public Health. 2022;19(9):5116. https:\/\/doi.org\/10.3390\/ijerph19095116.","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"3139_CR27","doi-asserted-by":"publisher","first-page":"92","DOI":"10.12965\/jer.2448186.093","volume":"20","author":"JH Lim","year":"2024","unstructured":"Lim JH, Kang EY, Park SJ, Kim BG. Effects of robot rehabilitation on the motor function and gait in children with cerebral palsy: a systematic review and meta-analysis. J Exerc Rehabil. 2024;20(3):92\u20139. https:\/\/doi.org\/10.12965\/jer.2448186.093.","journal-title":"J Exerc Rehabil"},{"issue":"4","key":"3139_CR28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057668","volume":"12","author":"SE Reedman","year":"2022","unstructured":"Reedman SE, Sakzewski L, McNamara L, et al. Study protocol for running for health (Run4Health CP): a multicentre, assessor-blinded randomised controlled trial of 12 weeks of two times weekly Frame Running training versus usual care to improve cardiovascular health risk factors in children and youth with cerebral palsy. BMJ Open. 2022;12(4):e057668. https:\/\/doi.org\/10.1136\/bmjopen-2021-057668.","journal-title":"BMJ Open"},{"issue":"3","key":"3139_CR29","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1111\/dmcn.14746","volume":"63","author":"D Pool","year":"2021","unstructured":"Pool D, Valentine J, Taylor NF, Bear N, Elliott C. Locomotor and robotic assistive gait training for children with cerebral palsy. Dev Med Child Neurol. 2021;63(3):328\u201335. https:\/\/doi.org\/10.1111\/dmcn.14746.","journal-title":"Dev Med Child Neurol"}],"container-title":["Systematic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13643-026-03139-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13643-026-03139-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13643-026-03139-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:24:03Z","timestamp":1775647443000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13643-026-03139-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3139"],"URL":"https:\/\/doi.org\/10.1186\/s13643-026-03139-4","relation":{},"ISSN":["2046-4053"],"issn-type":[{"value":"2046-4053","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]},"assertion":[{"value":"24 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"120"}}