Effects of telerehabilitation monitored home-based therapies on upper extremity function-related outcomes in children and adolescents with unilateral cerebral palsy: A systematic review

Introduction: Children and adolescents with cerebral palsy (CP) demonstrate proficient function if they can perform all tasks required for daily living. Telerehabilitation (TR) and monitoring can facilitate the execution of home-based (HB) therapies. This systematic review aimed to assess the scientific evidence regarding the effects of TR-monitored HB therapies on outcomes related to upper extremity function in children and adolescents with unilateral cerebral palsy (UCP). Methods Comprehensive searches were conducted across online databases, including the Cochrane Library, EMBASE, PubMed, Web of Science, and PEDro, as well as additional sources, from inception to October 2025. The inclusion criteria encompassed randomized controlled trials, whose risk of bias and methodological quality were evaluated using the Cochrane Risk-of-Bias Tool and the PEDro scale, respectively. A narrative synthesis approach was employed for data analysis. Results TR-monitored HB therapies showed positive improvements in hand coordination, dexterity, bimanual hand function, ADL motor and processing skills, occupational performance, and execution of functional goals in children and adolescents with UCP (predominantly spastic UCP studies) compared with the control interventions. Conclusions Telerehabilitation-monitored HB therapies showed potential to improve upper extremity function-related outcomes in children and adolescents with unilateral cerebral palsy (predominantly spastic UCP studies).