Abstract
Background/Objectives: Robotic therapies are emerging as a potential management strategy for individuals with cerebral palsy (CP). These devices apply mechanical and electrical forces to regulate neural excitability and promote motor learning. This review aimed to systematically assess and synthesize evidence from published systematic reviews and meta-analyses on the therapeutic benefits of robotics and exoskeletons for gait and postural balance in pediatric CP. Methods: A comprehensive search of PubMed, CINAHL, Scopus, and The Cochrane Library was conducted. Two independent reviewers screened records to identify studies that were: (1) written in English and published in peer-reviewed journals; (2) included participants <18 years with a diagnosis of CP; and (3) examined robotic therapies or exoskeletons targeting gait or postural balance. Methodological quality of included reviews was appraised with the Assessment of Multiple Systematic Reviews (AMSTAR) tool, and certainty of evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework. Results: 18 systematic reviews met the inclusion criteria, encompassing 256 primary studies and 5092 participants. Overall methodological quality of the included reviews was rated as moderate to good. A variety of robotic and exoskeleton systems were noted across studies, with heterogeneous protocols and outcomes. Several reviews reported modest improvements in gait and postural balance; however, the findings were inconsistent, and pooled effects, where available, did not yield definitive conclusions regarding efficacy. Conclusions: Robotic and exoskeleton interventions may offer benefits for gait and postural balance in children and adolescents with CP, but the current evidence base remains inconclusive. Additional high-quality research is required to determine effectiveness more definitively.