Effects of dual-task training on gross motor function, balance, and gait in children with cerebral palsy: a systematic review and meta-analysis

Background Children with cerebral palsy (CP) often experience cognitive–motor interference, which limits the ecological validity of traditional single-task rehabilitation. Dual-task training (DTT) integrates cognitive and motor tasks, potentially addressing this issue, but its effectiveness remains unclear due to protocol and outcome variability. Methods A PRISMA 2020–compliant systematic review and meta-analysis of randomized controlled trials was conducted. Databases including PubMed, Web of Science, Embase, Scopus, the Cochrane Library, and CNKI were searched (2015 to October 16, 2025). Outcomes included balance capacity, gross motor function (GMFM Dimensions D/E), and functional mobility (Timed Up and Go, TUG). Risk of bias was assessed using RoB 2, and certainty of evidence with GRADE. Results Eleven RCTs ( n = 582) were included. Compared with conventional rehabilitation, DTT improved balance capacity (SMD = 1.11, 95% CI 0.89–1.33; I 2 = 0%), GMFM Dimension D (MD = 5.05, 95% CI 1.30–8.79; I 2 = 80%) and Dimension E (MD = 5.23, 95% CI 2.34–8.12; I 2 = 41%), and TUG performance (MD = −2.49 s, 95% CI − 3.90 to −1.09; I 2 = 69%). Overall risk of bias was “some concerns,” with certainty of evidence ranging from low to moderate. Egger’s test for balance capacity showed no small-study effects ( p = 0.721). Conclusion DTT may improve balance, gross motor function, and functional mobility in children with CP. Given outcome-specific heterogeneity and moderate certainty, results should be interpreted cautiously. Future well-powered trials with standardized protocols and longer follow-up are necessary. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42046832672 , identifier (CRD42046832672).