INTRODUCTION: Cerebral palsy (CP) is the most common childhood disability, affecting 1.5 to 3 per 1000 live births. Physical exercises have been shown to improve muscle and limb outcomes in CP. This systematic review critically appraises existing systematic reviews on the effects of physical activity and exercise on physical, functional, and psychosocial outcomes in individuals with CP compared to those without. METHODS: Using a PICO framework, the question was: In patients with CP, do physical activity and exercise improve muscle- and limb-related outcomes compared to no intervention or usual care? PubMed, Cochrane, ISI Web of Science, and Embase were searched for systematic reviews meeting inclusion criteria. Seven reviews focusing on exercise-related outcomes in CP were synthesized. RESULTS: Exergaming significantly improved fine motor dexterity (SMD 3.12) but not gross manual dexterity. Progressive resistance and general physical activity increased muscle strength (SMD 0.59), while aerobic exercise showed mixed results. Task-oriented training led to large improvements in gross motor function (SMD 6.04 to 11.05) and functional independence (SMD 6.44). VR-based and aerobic interventions had modest or nonsignificant effects on mobility, balance, and walking. Adverse events were infrequently reported and generally mild. Task-oriented and VR-assisted training showed the most consistent benefits, though heterogeneity and incomplete reporting limit conclusions. CONCLUSION: Physical exercises, particularly task-oriented and VR-assisted training, improve motor and limb functions in CP. Future research with longer follow-up, larger samples, and better safety reporting is needed to confirm clinical impact. FUNDING: The King Salman Center for Disability Research, Grant/Award Number: KSRG-2024-036. PROSPERO registration number: CRD42025646412.

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