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Home-based telerehabilitation on motor function in youth with cerebral palsy: systematic review and meta-analysis
Patricia Domínguez-López1,2, Cristina Lirio-Romero3,4, María Coello-Villalón1,2,5
1Asociación de Ayuda a la Parálisis Cerebral "Virgen del Valle" (APACE), Avda. Río Boladiez, Toledo, Spain.
Aim:
Neurodevelopmental disorders (NDDs) affect motor, cognitive and social functioning in children and adolescents, limiting autonomy and quality of life. Limited access to specialized services may hinder rehabilitation, making home-based telerehabilitation an alternative. This study evaluated its effectiveness on motor function in individuals aged 3-18 years with NDDs compared with usual care, conventional rehabilitation, or non-telehealth interventions.
Methods:
Randomized controlled trials (RCTs) published from database inception (earliest eligible trial, 2014) to January 2026 were identified in PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Risk of bias and evidence certainty were assessed using RoB 2.0 and GRADE. Standardized mean differences (SMDs) were pooled using a random-effects model.
Results:
Eight RCTs (n = 419) were included; all involved children with cerebral palsy (CP), although the review targeted NDDs. Meta-analyses suggested possible improvements in gross motor function (SMD 1.29, 95% CI 0.11 to 2.47; I² = 96%), although estimates were influenced by heterogeneity and outlier studies. Effects on fine motor function were smaller and non-significant (SMD 0.62, 95% CI -0.25 to 1.49; I² = 90%).
Conclusions:
Although this review targeted NDDs, all studies involved youth with CP. Home-based telerehabilitation may support gross motor rehabilitation, but low-certainty evidence and heterogeneity limit confidence and generalizability.
Impact:
This systematic review and meta-analysis suggests that home-based telerehabilitation may improve gross motor function in children and adolescents with cerebral palsy, although effect estimates were influenced by substantial heterogeneity and outlier studies. By synthesizing evidence from randomized controlled trials, this review highlights the potential role of home-based telerehabilitation as a complementary rehabilitation approach, while emphasizing important methodological variability across studies. The findings suggest that home-based telerehabilitation may represent a complementary rehabilitation approach for children and adolescents with cerebral palsy. However, further high-quality studies are needed to confirm effectiveness, determine clinical relevance, and better understand implementation-related factors such as adherence and intervention delivery.
