Benefits and limitations of robotic gait exoskeletons in functional rehabilitation of children with cerebral palsy: an umbrella review

Abstract

PURPOSE: Cerebral palsy (CP) is a group of non-progressive brain disorders affecting posture and movement. Children show locomotor impairments, including slow, asymmetric, and unstable gait, limiting daily mobility. Robot-Assisted Gait Training (RAGT) is used in CP rehabilitation, but its effectiveness remains heterogeneous. MATERIALS AND METHODS: Spatiotemporal gait parameters (walking speed, step length) were analyzed with GMFM-88 functional outcomes (dimensions D and E). No other clinical, kinematic, kinetic, or EMG measures were reported. Effects were expressed as standardized mean differences with 95% confidence intervals; significance was based on whether intervals crossed zero. RESULTS: RAGT improves overall motor function, especially GMFM D and E, supporting its complementary role. Effects on gait parameters are limited, with no consistent advantage over treadmill or physiotherapy. GMFM-88 dimension D gains were limited and heterogeneous, whereas dimension E showed more consistent improvements, particularly with RAGT alone or versus conventional therapy. CONCLUSIONS: These findings highlight RAGT's role in enhancing gross motor function in children with CP, while improvements in spatiotemporal gait parameters remain inconsistent. Overall, RAGT can be considered a valuable adjunct to conventional rehabilitation, emphasizing the need for tailored interventions and further research to optimize gait outcomes in pediatric CP populations.

The authors' abstract, as published at the source. Disability and Rehabilitation, 2026 · DOI ↗