Home-based therapy for upper limb activity in children and adolescents with unilateral cerebral palsy: systematic review and meta-analysis.

Abstract

To analyze the effect of home-based therapy for upper limb activity in children and adolescents with unilateral cerebral palsy. PubMed, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and PEDro were systematically searched from inception to March 2026 for experimental studies addressing the effect of home-based therapies in participants aged from 2 to 18 years old. The DerSimonian and Laird method was used to compute pooled estimates of the standardized mean differences (SMD) and their respective 95% confidence intervals (CI). Subgroup analyses were performed based on the dosage of interventions. Seventeen studies were included in this systematic review. Home-based therapies showed improvement in upper limb activity (SMD = 0.45; 95% CI: 0.30-0.60). No statistically significant differences were observed in relation to the intensity of intervention (hours per week). Meta-regression analysis revealed that none of the implementation-related moderators-including parental involvement, delivery format, dose profile, task relevance and contextual support-had a statistically significant effect on intervention outcomes (<i>p</i> > 0.05). High-intensity home-based therapies have demonstrated promising findings in improving upper limb activity in children and adolescents with unilateral cerebral palsy. Further high-quality studies may assess the influence of intervention characteristics.