This study aims to evaluate the effects of three different physiotherapy approaches-robot-assisted gait training, hydrotherapy, and conventional physiotherapy-on muscle strength, balance, functional mobility, and psychological adjustment in children diagnosed with spastic hemiparetic cerebral palsy. A total of 45 ambulatory children aged 5 to 15 years will be randomly assigned to one of the three intervention groups. All participants will receive therapy twice a week for six weeks.
Muscle strength will be assessed using a handheld dynamometer, balance with the Pediatric Balance Scale, mobility with the Timed Up and Go test, and psychological adjustment with a standardized behavioral checklist. The study will help determine which therapeutic approach provides the most benefit in improving physical function and emotional well-being. Results may guide healthcare providers and families in selecting the most effective rehabilitation method for children with cerebral palsy.
Children aged between 5 and 15 years
Diagnosed with spastic hemiparetic cerebral palsy
Classified as Level I or II on the Gross Motor Function Classification System (GMFCS)
Able to follow simple instructions and participate in therapy sessions
Severe cognitive or mental impairment that interferes with communication
Lower extremity joint contractures preventing use of robotic gait device
Uncontrolled cardiac disease
Active infection at the time of intervention
Parallel
Robot-assisted gait training using Lokomat
BehavioralThis intervention involves robotic-assisted gait training with the Lokomat device. Sessions will last 40 minutes, twice a week for 6 weeks. The intervention targets lower extremity motor function in children with spastic hemiparetic cerebral palsy. The robotic system provides adjustable support and real-time feedback to improve gait patterns and mobility.
Hydrotherapy
BehavioralParticipants will engage in supervised aquatic therapy including structured exercises in a therapeutic pool. Each session lasts 40 minutes, twice a week, for 6 weeks. Exercises include water walking, floating resistance training, jumping, and balance activities designed for children with spastic hemiparetic cerebral palsy to improve strength, coordination, and functional mobility.
Conventional Physiotherapy
BehavioralThis intervention includes 20 minutes of faradic electrical stimulation and 20 minutes of therapeutic exercises such as stretching, positioning, range of motion, and gait training. Administered twice a week for 6 weeks. The protocol aims to support neuromuscular activation and improve gait and mobility in children with spastic hemiparetic cerebral palsy.
Muscle Strength
Change in lower extremity muscle strength measured by hand-held dynamometer (MicroFET® 2) at baseline and after 6 weeks of intervention.
Balance
Change in balance performance assessed by Pediatric Balance Scale (PBS).
Functional Mobility
Change in mobility measured using the Timed Up and Go (TUG) test.
Psychological Adjustment
Change in psychosocial adjustment scores based on the Hacettepe Psychological Adjustment Scale for Children (parent-rated).
Treatment Tolerance and Adherence
Number of completed sessions out of 12 scheduled sessions during the 6-week intervention period.
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Istanbul Arel University
Lead sponsor
Kayseri University
Collaborator
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