Comparative Efficacy of Robotic-assisted versus Conventional Orthotic Therapies in Cerebral Palsy Rehabilitation: A Narrative Review
Rajesh Kumar MohantyAbstract
Background:
Robotic-assisted approaches, primarily robot-assisted gait training (RAGT) and more conventional orthotic therapies, mainly ankle-foot orthoses and related lower-limb orthoses, are both widely used to improve mobility, gait, balance and function in children with cerebral palsy (CP).
Objectives:
To synthesise recent evidence comparing the efficacy of robotic-assisted interventions and conventional orthotic therapies in CP rehabilitation.
Methods:
A narrative review of randomised trials, systematic reviews and meta-analyses (2015–2025) for robot-assisted and orthotic interventions in CP was conducted. Key sources include randomised controlled trials (including a 2024 multicenter randomised controlled trial), multiple systematic reviews/meta-analyses (2022–2024) and recent orthotics evidence syntheses. Searches performed across PubMed/PMC, and major journals and ultimately 24 review articles are cited.
Results:
There are very few direct trials comparing robotic systems to orthotic devices (AFOs/KAFOs); and most comparisons are between RAGT and conventional physiotherapy or treadmill training rather than bracing. RAGT and wearable exoskeleton studies report consistent short-term improvements in gross motor function, balance and some gait metrics compared with conventional therapy (CT), with at least one large randomised clinical trial showing significant gains in GMFM, balance and gait pattern after RAGT versus CT. Conventional orthoses (AFOs) demonstrate improvements in gait kinematics, energy cost and stability, especially when individually tuned; benefits are device- and goal-specific. Cost, access, required infrastructure and long-term sustainability differ markedly between approaches.
Conclusions:
Robotic-assisted therapies show promise for improving gait, balance and gross motor outcomes in children with CP in the short term; conventional orthoses remain an effective, low-cost, pragmatic option for improving gait mechanics and daily function.