To evaluate the effectiveness of HEPs in improving motor function, ADL, and participation in children with CP, contributing to evidence-based interventions
A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, registered with INPLASY (registration number INPLASY202290053). The search spanned six databases: PubMed, ClinicalTrials.gov, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Cochrane Library, Psychological Information Database (PsycINFO), and MEDLINE for studies published up to June 2024. Studies assessing the impact of HEPs on motor function and ADL in children with CP were included. Two independent reviewers performed data extraction and quality assessment. Meta-analyses were conducted using a random-effects model, with standardized mean difference (SMD) as the summary statistic. Heterogeneity was assessed using the I² statistic, with significance set at p 0.05.
Six high-quality studies involving 310 participants (111 females, 137 males, and 62 of unspecified gender) aged 2 to 16 years met the inclusion criteria. The HEPs included Wii Sports Resort™ training, constraint-induced movement therapy (CIMT), strength training, and intensive bimanual training (IBT), with varying frequencies and durations. The meta-analysis revealed a small, positive, but statistically non-significant improvement in motor function (SMD = 0.033, 95% CI -0.106 to 0.156, p = 0.664, I² = 20.49%). Both studies assessing ADL, involving 139 participants, reported positive improvements, while no study examined participation.
Home-based exercise programs demonstrate potential for enhancing motor function and ADL in children with CP, though the results warrant further investigation to confirm efficacy and improve implementation strategies.
Although HEPs show a trend toward improving motor function and ADL in children with CP, the results were not statistically significant. This study underscores the need for further research to optimize HEPs, explore long-term outcomes with larger sample sizes and extended follow-up periods, and assess their impact on participation, aligning with WHO standards for promoting physical activity in children with disabilities.
Home-Based Exercise
Functional Outcomes
