A systematic review and meta-analysis of randomized controlled trials to investigate the impact of active body-weight-supported treadmill training on gait function of children and adolescents with cerebral palsy.

PURPOSE: To study the efficacy of active body-weight-supported treadmill training (BWSTT) on gait speed, endurance, step and stride length, cadence, mobility, brain integrity, and function in children with cerebral palsy (CP).

MATERIALS AND

METHODS

ScienceDirect, Scopus, MEDLINE, Cochrane, PEDro, CINAHL, Web of Science and Google Scholar were searched on July 15th, 2026. Randomized controlled trials (RCTs) that used BWSTT and assessed gait and brain activity were investigated. Risk of bias was assessed using ROB2.

RESULTS

Seventeen studies were reviewed. Most studies were rated as having some concerns in risk of bias assessment. Gross motor function measure (GMFM) dimension D (MD = 3.3; p = 0.002) and E (MD = 2.56; p < 0.001) improved significantly after active BWSTT. No changes were observed in mobility, speed, stride length, cadence, and endurance. The certainty of the evidence for speed, endurance, TUG, stride length, and cadence was very low, and for GMFM was low.

CONCLUSION

Active BWSTT may produce clinically relevant improvements in GMFM of children and adolescents with CP, whereas its effects on broader walking performance and underlying neural mechanisms remain uncertain. However, the low to very low certainty of evidence warrants further high-quality RCTs examining gait outcomes, brain plasticity, and their relationship.