Community-based RoboGym training improves gross motor function in ambulatory children with cerebral palsy

Children with cerebral palsy (CP) require sustained, intensive, task-specific rehabilitation, yet conventional community-based rehabilitation (CBR) is often limited by insufficient training dose and lack of assistive technologies. In this pragmatic randomized controlled trial, 60 children with CP (mean age 10.4 ± 1.4 years; Gross Motor Function Classification System levels II–III) were allocated 1:1 to a community-based RoboGym (CRG) integrating five robotic modalities in a task-oriented circuit, or to conventional CBR. Both groups received 90-min sessions twice weekly for 6 months. The primary outcome was the Gross Motor Function Measure-66 (GMFM-66); secondary outcomes were the Pediatric Balance Scale (PBS), Functional Independence Measure (FIM), and Pediatric Quality of Life Inventory (PedsQL). Significant Time × Group interactions favored CRG for GMFM-66 ( p = 0.048), PBS ( p = 0.048), and the PedsQL emotional ( p = 0.039) and social functioning ( p = 0.015) domains; differences in FIM ( p = 0.065) and PedsQL physical functioning ( p = 0.076) also favored CRG but were not statistically significant. The CRG mean GMFM-66 percentile advanced from the 36th to the 48th (individual effect size (iES) = 1.14, large), whereas CBR remained near baseline (iES = 0.29). A higher proportion of CRG participants exceeded the minimal detectable change threshold (37–63% vs. 17–27%), a difference that was statistically significant for GMFM-66, PBS, and FIM. Multi-modal robotic circuit training may offer a scalable community-based approach to CP management, although confirmation in larger multicenter trials is required. Clinical Research Information Service, KCT0006417, registered [03 August 2021].