Context-based interventions for functionality and social participation in children with cerebral palsy: a scoping review

Context-based interventions (CBIs) have gained increasing relevance in paediatric rehabilitation, as they aim to improve activity and participation by modifying environmental factors that affect functionality in children with cerebral palsy (CP). This review aims to synthesise and present the available evidence on CBIs designed to enhance activity and participation in children with CP. A scoping review was conducted following PRISMA-ScR guidelines. A protocol was registered in the open science framework (OSF: https://doi.org/10.17605/OSF.IO/ZBNYV). A systematic search was performed in PubMed, SCOPUS, Web of Science (WOS), and EBSCO databases between 2014 and 2024. Inclusion criteria focused on intervention studies targeting children with CP (0–13 years) and measuring activity and/or participation. A total of 8367 records were identified; 14 studies were included after screening. Fourteen papers were included, the selected studies addressed home-based interventions involving caregivers and technologies such as exergaming, telerehabilitation, and virtual reality. These strategies showed positive effects on gross motor function, participation, and goal attainment. Although all interventions showed promising results, methodological variability limited direct comparisons. Most studies used tools such as gross motor function measure (GMFM), Canadian occupational performance measure (COPM), paediatric evaluation of disability inventory (PEDI), and goal attainment scale (GAS) to measure outcomes. Contextual interventions were feasible, family-centred, and low-cost, but often required ongoing professional support. CBIs offer a promising approach to enhance activity and participation in children with CP. Their integration into rehabilitation programs may optimise resource use and promote inclusion. Further research is needed to standardise protocols and evaluate long-term effectiveness.