Abstract
BACKGROUND: To systematically evaluate the efficacy of sling exercise training on balance and gross motor movement in children with cerebral palsy, and to investigate the effects of different intervention times and ages on treatment outcomes. METHODS: Randomized controlled trials on sling exercise training for children with cerebral palsy published in full text from CNKI, Wanfang datebase, PubMed, Cochrane Library, Web of Science, and Scopus were searched from the time of build to November 2023. Literature screening, data extraction, and quality assessment were performed independently by 2 researchers, and Meta-analysis was performed using RevMan5.4 and Stata17.0 software. RESULTS: A total of 12 studies with 725 patients were included sling exercise training significantly improved balance (I2 = 0%, mean difference [MD] = 3.42, 95% CI: 2.93-3.92, P < .00001), gross motor function (I2 = 0%, MD = 5.90, 95% CI: 1.50-10.29, P < .00001), standing function (I2 = 14%, MD = 2.73, 95% CI: 2.17-3.29, P < .00001) walking and running and jumping function(I2 = 79%, MD = 5.93, 95% CI: 3.82-8.04, P < .00001) and 10-meter maximum walking speed(I2 = 58%, MD = 1.47, 95% CI: 0.52-2.42, P = .003) in children with cerebral palsy. Subgroup analyses of balance showed that children in the 5 + age group (I2 = 0%, MD = 3.73, 95% CI: 2.55-4.91, P < .00001) had better outcomes relative to the 4-5 year old group (I2 = 23%, MD = 3.49, 95% CI: 2.88-4.09, P<0.00001) and the under 4 year old group (I2 = 0%, MD = 282.73, 95% CI: 1.57-4.06, P < .00001). Subgroup analyses of walking and running and jumping function showed that a 6-month treatment course(I2 = 0%, MD = 5.93, 95% CI: 3.82-8.04, P < .00001) had better efficacy relative to a 3-month treatment course(I2 = 0%, MD = 4.11, 95% CI: 2.84-5.39, P < .00001). CONCLUSION: Sling exercise training significantly improves balance and gross motor function in children with cerebral palsy, and The average age of 5+ years is a critical period for the development of balance in children with cerebral palsy, and the treatment course is an important factor affecting walking and running and jumping function.