Abstract

Background/Objectives: Children with cerebral palsy (CP) commonly present impairments in gross motor function and limitations in activities of daily living (ADLs), which negatively impact independence and quality of life. Identifying effective rehabilitation strategies is essential to promote functional development. To evaluate the effectiveness of occupational therapy (OT) interventions on gross motor function and independence in ADLs among children with CP. Methods: Seven electronic databases were searched through August 2025. The review protocol was registered in PROSPERO (CRD42025634706) and conducted in accordance with PRISMA guidelines. Methodological quality and certainty of evidence were assessed using the Oxford Centre for Evidence-Based Medicine scale, the Risk of Bias 2 (RoB 2) tool, and GRADEpro. Randomized controlled trials reporting OT interventions targeting gross motor and ADL outcomes were included. Results: Of 594 identified records, 14 studies met the inclusion criteria. Meta-analysis indicated that OT interventions significantly improved gross motor function (GMFM-66; ES = 0.32 [0.01-0.63], p = 0.04), mobility (PEDI-Mobility; ES = 0.46 [0.05-0.87], p = 0.02), and occupational performance (COPM-Performance; ES = 2.63 [1.14-4.11], p = 0.001) and satisfaction (COPM-Satisfaction; ES = 2.17 [0.82-3.51], p = 0.002). No significant changes were observed in self-care (PEDI-Self-Care; ES = 0.19 [-0.14-0.53], p = 0.26). Conclusions: Evidence suggests that OT interventions effectively enhance gross motor function, mobility, and occupational performance in children with CP. These results support the integration of OT within pediatric rehabilitation programs to optimize functional outcomes.