Children with global developmental delay (GDD) often present with motor dysfunction, including impaired walking ability and insufficient balance control. Conventional rehabilitation has limitations in improving walking ability and balance control; therefore, more effective interventions need to be explored.

To compare the effects of Computer Assisted Rehabilitation Environment (CAREN) intervention and conventional intervention on motor function in children with GDD, and to provide evidence for optimizing rehabilitation programs.

Thirty children with GDD who received rehabilitation training at the Bayi Rehabilitation Center of Sichuan Province from July to November 2025 were enrolled. They were randomly assigned, using a random number table, to the CAREN group (n=15) and the conventional group (n=15). The conventional group received conventional intervention, including straight-line walking, grid walking and rhythmic walking, standing on a balance pad with weight shifting, obstacle crossing, and functional walking. The CAREN group received CAREN intervention, including Balloon Zoo, 2D Maze, Traffic Command, and Footstep Tracking. Both groups received 60 min of training per session, once daily, 6 days per week, for 12 consecutive weeks. Motor function was evaluated using indicators of walking and balance performance. Walking performance indicators included the Gross Motor Function Measure-88 (GMFM-88) dimensions D and E scores, 6-minute walk distance (6MWD), and spatiotemporal gait parameters. Balance performance indicators included static postural stability (PS) under four postures, namely eyes-open bipedal standing, eyes-closed bipedal standing, eyes-open tandem standing, and eyes-open single-leg standing, and dynamic balance assessed using time to stability (TS) in four directions, namely forward, backward, leftward, and rightward recovery times.

Before intervention, there were no significant differences between the two groups in GMFM-88 dimensions D and E scores, 6MWD, spatiotemporal gait parameters, or balance performance indicators (P>0.05). After intervention, compared with the conventional group, the CAREN group showed higher GMFM-88 dimensions D and E scores, longer 6MWD, greater increases in step length and gait speed, a greater decrease in the percentage of stance phase and a greater increase in the percentage of swing phase, lower PS values under eyes-open bipedal standing, eyes-open tandem standing, and eyes-open single-leg standing, and shorter TS recovery times in all four directions (P<0.05). Significant differences were observed in all indicators before and after intervention in both groups (P<0.05).

Compared with conventional intervention, CAREN intervention may be more effective in improving motor function in children with GDD. This study provides preliminary evidence supporting the application of the CAREN system in the rehabilitation of children with GDD.