Dual task training enhances gross motor function, reduce fatigue and minimize cognitive motor interference in children with diplegic cerebral palsy by promoting neuroplasticity and improving dual task processing. Vestibular stimulation improve balance triggering the vestibulospinal reflex, which play a key role in maintaining posture and reducing the risk of fall. Integrating dual task training with vestibular stimulation can provide a more holistic rehabilitation strategy by enhancing balance and posture stability through improved vestibular system activation, supporting motor and cognitive coordination by challenging the brain to handle tasks concurrently, and boosting functional mobility by mimicking everyday situations that require divided attention. This RCT evaluates its effectiveness in optimizing motor-cognitive integration, functional mobility and endurance compared to conventional motor training approaches.
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History of recent orthopedic surgery (within the past 6 months).
Parallel
Conventional Physical Therapy With Dual Task Training
BehavioralParticipants undergo a 50-minute session, 3 times/week for 12 weeks. Warm-up (10 min): Trunk and lower extremity ROM exercises (Lee et al., 2021). Conventional PT (20 min): Wide leg squatting, hip flexion/extension, hip abduction/adduction, knee extension/flexion with ankle weights (Uysal et al., 2024). Dual Task Training (20 min): Balance activities (semi-tandem stance, tiptoe, heel stance, one-leg stance, line walking) with cognitive activities (verbal fluency, simple math, memory recall, daily routine recall).
Dual Task Training With Vestibular Stimulation
BehavioralParticipants undergo a 50-minute session, 3 times/week for 12 weeks. Warm-up (10 min): Trunk and lower extremity ROM exercises (Lee et al., 2021). Dual Task Training (20 min): Same as Intervention 1 (balance + cognitive tasks). Vestibular Stimulation (20 min): Sliding activity on physio roll (10 repetitions) and vertical bouncing on physio roll for 10 minutes (Parashar et al., 2017).
Gross Motor Function Measure (GMFM-88)
The GMFM-88 is a standardized observational instrument designed to measure changes in gross motor function in children with cerebral palsy. Scores range from 0-100, with higher scores indicating better gross motor performance.
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