1. Evaluate the effect of a structured aquatic therapy programme on static balance in children with spastic diplegic cerebral palsy. 2. Assess the effect of the same programme on dynamic balance in this patient population. 3. Compare balance outcomes between children receiving aquatic therapy and those receiving conventional land-based physiotherapy.
Confirmed diagnosis of spastic diplegic cerebral palsy by a paediatric neurologist or developmental paediatrician
Age between 5 and 12 years
Classified at GMFCS levels I-III
Bilateral lower limb spasticity with a Modified Ashworth Scale (MAS) score of ≥ 1
Athetoid, ataxic, or mixed-type cerebral palsy
GMFCS levels IV or V (non-ambulatory children)
Uncontrolled seizure disorder or epilepsy not managed by medication
Open wounds, skin infections, or active dermatological conditions contraindicating water immersion
Parallel
aquatic therapy
Other interventionAquatic therapy is a specialized rehabilitation approach that utilizes the physical properties of water, including buoyancy, hydrostatic pressure, and resistance, to facilitate movement and improve functional performance in children with diplegic cerebral palsy. The aquatic environment reduces weight-bearing demands, allowing safer practice of balance, gait, strength, and motor control activities while minimizing joint stress. Regular aquatic therapy may enhance muscle strength, postural stability, mobility, and overall participation in daily activities.
land exercise program
Other interventionThe control group participated in a conventional land-based exercise program consisting of stretching, strengthening, balance, and functional mobility exercises. The program focused on improving lower-extremity muscle strength, postural control, gait performance, and overall functional abilities through activities performed on a stable surface. Exercises were progressed according to each participant's abilities while maintaining consistency in treatment duration and frequency across the study groups.
static balance
Static and dynamic balance will be assessed using the Biodex Balance System. Stability indices will be recorded to evaluate postural control and balance performance
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