# A scoping review of the application scope of digital technologies in lower limb rehabilitation and balance training for children with cerebral palsy

## TL;DR

This review explores how digital technologies help children with cerebral palsy improve their lower limb function and balance through rehabilitation.

## Contribution

The study provides a comprehensive overview of digital technologies' application scope and barriers in pediatric cerebral palsy rehabilitation.

## Key findings

- Robotics and exoskeletons significantly improve gait and balance in children with CP.
- Virtual reality and game-based interventions enhance motor engagement and motivation.
- Internet-based platforms show promise for home-based rehabilitation but face cost and technical barriers.

## Abstract

This study aims to systematically review the application scope of digital technologies in lower limb rehabilitation and balance training for children with cerebral palsy (CP), identify the intervention effects and barriers associated with various types of technologies, and provide evidence-based guidance for clinical practice and home-based rehabilitation.

Following the Joanna Briggs Institute (JBI) scoping review framework, a comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for studies published from January 1, 2008, to January 1, 2025. The included studies were published between 2008 and 2024. Eligible studies included children with CP aged ≤18 years, involving the application of digital technologies in any form to lower limb or balance-related assessment, intervention, validation, or prediction Two reviewers independently screened the literature and extracted valid data. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT).

A total of 85 studies were included, encompassing five major categories of digital technologies: robotics/exoskeletons, virtual reality, sensors with real-time feedback, internet-based telerehabilitation, and game-based technologies. Robotics and exoskeletons significantly improved gait and balance in children through repetitive and precise training. Virtual reality and game-based interventions enhanced postural control, motor engagement, and motivation. Sensor and feedback technologies emphasize real-time monitoring and personalized correction. Internet platforms showed potential value in home-based rehabilitation and functional training. However, high costs, technical complexity, and limited cultural adaptability remain major barriers to widespread adoption and implementation.

Digital technologies have been evaluated for lower-limb and balance rehabilitation in children with CP, and several studies reported improvements in gait- and balance-related outcomes and training engagement. Future research should strengthen methodological rigor, cost-effectiveness evaluation, and long-term follow-up to better inform implementation and equity considerations.

https://doi.org/10.17605/OSF.IO/TMK93, identifier TMK93.