To evaluate the effectiveness of magic-themed interventions in improving daily bimanual task performance in children with unilateral spastic cerebral palsy (CP) and to elucidate the variability in outcomes. METHOD: This systematic literature review searched databases including Embase, MEDLINE, Scopus, Cochrane Central, and CINAHL. Outcome measures selected for the meta-analysis included the Children's Hand-use Experience Questionnaire, its three subscales, and the Besta subscale (C) The overall efficacy of magic-themed interventions was analysed using Hedges' g as the summary measure for these outcomes. Subgroup analysis compared the efficacy of different modes of training, and a meta-regression investigated the impact of training duration. RESULTS: Analyses of four studies involving 78 children showed magic-themed training significantly improved bimanual task performance (Hedges' g 0.327, 95% confidence interval (CI) 0.107 to 0.547, p = 0.004), especially in group settings (Hedges' g 0.435, 95% CI 0.176 to 0.693, p = 0.001), compared with non-significant gains from video interventions (Hedges' g 0.041, 95% CI -0.380 to 0.462, p = 0.850). Additionally, training duration positively correlated with performance gains (coefficient 0.0076 per hour, p = 0.001). INTERPRETATION: Magic-themed training, especially through group sessions and extended durations, enhances bimanual skills in children with unilateral spastic CP.

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