Effectiveness of home-based exercise programme in improving function, activity and participation for children with cerebral palsy: a systematic review and meta-analysis

Background Cerebral palsy (CP) is a neurodevelopmental disorder characterized by motor impairments that impact children's activities of daily living (ADL). Home-based exercise programs (HEPs) are emerging as a promising intervention. The question arises: What is the effectiveness of home exercise programme in the management of function, activity of daily living and participation in children with cerebral palsy? Methods A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across 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. Data extraction and quality assessment were independently performed by two reviewers. 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. Results 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. Conclusion Home-based exercise programs show a trend toward improving motor function and ADL in children with CP, though the results were not statistically significant. Further research is needed to optimize these programs, explore long-term outcomes with larger sample sizes and extended follow-up periods and assess their impact on participation.