Effects of exercise on cognitive function in Cerebral Palsy: A systematic review and Bayesian meta-analytic dose-response modeling

This systematic review and meta-analysis evaluated the effects of exercise on cognitive function in individuals with cerebral palsy (CP). Studies were identified from five databases, with the final search on March 15, 2025. Pooled results suggested exercise may improve cognitive performance and daily functioning, although evidence remains limited due to few studies, modest effect sizes, and methodological variability. Subgroup analyses indicated greater improvements in participants over 12 years, while working memory appeared less responsive. Moderate-to-vigorous intensity interventions tended to be beneficial, whereas programs involving virtual reality or combined cognitive-physical components yielded inconsistent findings. Bayesian dose-response modeling indicated a non-linear relationship between exercise volume and cognitive outcomes, with optimal effects around 580 MET-minutes per week, beyond which improvements plateaued. These findings highlight exercise as a promising non-pharmacological approach to support cognition in CP, while underscoring the need for further high-quality studies to confirm modality- and intensity-specific recommendations.