Effects of Robot-Assisted Therapy on Upper Limb Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis

To investigate how effective is robot-assisted therapy vs. comparison intervention (no intervention, placebo or a conventional intervention) in improving affected upper limb outcomes (any related to the upper limb function, such as muscle strength, motor coordination, tones, reach, and grasp) in children with cerebral palsy (CP). Searches of this systematic review with meta-analysis were conducted on Cochrane, LILACS, MEDLINE, PEDro, and Scielo databases. Studies with children with CP, which delivered robot-assisted therapy on upper limb were included. Four studies were included. The meta-analysis was performed for all Quality of Upper Extremities Skills Test subscales and muscle tone. Robot-assisted therapy, compared with conventional therapy, improved dissociated movements by 4,3 points (95%CI 0.9 to 7.6, I²=0%, <i>p</i> = 0.01), grasp by 5,7 points (95%CI 3.0 to 8.3, I²=0%, <i>p</i> &lt; 0.001), and weight bearing by 8,7 points (95%CI 2.2 to 15.2, I²=0%, <i>p</i> = 0.008). The quality of evidence for all measures was rated as moderate. Overall, robot-assisted therapy appears to be effective in improving dissociated movements, grasp, and weight-bearing, but not for muscle tone and protective extension in children with CP. However, these results need to be interpreted cautiously.