AIM: To systematically review the efficacy of physiotherapy interventions to improve gross motor capacity, performance and societal participation in children aged 5 to 17 years with an acquired brain injury (ABI). METHODS: Randomized and non-randomized controlled trials, cohort, case series, case-control and case studies were included and classified according to grades of evidence. Methodological quality of studies was assessed using the Downs and Black (D+B) scale and quantitative data was analysed using effect sizes. RESULTS: Two home-based studies investigated functional strength training (one 'randomized controlled trial, n = 20, level 2b, D+B 16/32 and one non-randomized self-control study, n = 19, level 4, D+B 15/32). Four studies evaluated virtual reality including: one pilot study, n = 50, level 4, D+B 22/32; one single-subject, non-concurrent, randomized multiple baseline study, n = 3, level 4, D+B 15/32; one case series study, n = 2, level 4, D+B 15/32; one case study, n = 1, level 4, D+B 15/32. Effect sizes for the 'randomized controlled trial ranged between 0.30 to 1.29 for the Functional Reach and Timed Up and Go outcome measures. CONCLUSION: There is preliminary evidence to support the efficacy of physiotherapy interventions to improve gross motor outcomes in children with an ABI. Both functional strength training and virtual-reality based therapy are potential treatment options for clinicians to prescribe in either home or clinical settings.

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