Spastic Diplegic Cerebral Palsy

Cerebral palsy can affect walking ability, muscle control, functional mobility, and psychosocial well-being in children. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that may support motor learning, while virtual reality (VR) rehabilitation provides interactive, repetitive, and task-specific motor training. This randomized controlled trial will investigate whether active tDCS combined with VR rehabilitation provides additional benefits compared with sham tDCS combined with the same VR rehabilitation and conventional physical therapy in children with spastic cerebral palsy. A total of 42 children aged 8 to 16 years with spastic diplegic cerebral palsy and Gross Motor Function Classification System (GMFCS) levels I-III will be randomly assigned in a 1:1:1 ratio to one of three groups: active tDCS plus VR, sham tDCS plus VR, or conventional physical therapy. Each group will receive 18 treatment sessions over six weeks, with three sessions per week. Outcomes will be assessed before treatment, after nine sessions, and after 18 sessions. The primary outcomes will be gait performance measured using the 10-Meter Walk Test and self-esteem measured using the Rosenberg Self-Esteem Scale. Secondary outcomes will evaluate spasticity, gross motor function, functional mobility, and functional independence.

Children with spastic diplegic cerebral palsy commonly experience difficulties with balance and may also have challenges involving attention, working memory, cognitive flexibility, and inhibitory control. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that may influence motor-cortical excitability, while virtual reality (VR) rehabilitation provides repetitive, interactive, and task-oriented training. This randomized controlled trial will investigate whether active tDCS combined with VR rehabilitation improves balance and executive functions more than sham tDCS combined with the same VR rehabilitation or conventional physical therapy in children with spastic diplegic cerebral palsy. A total of 42 children aged 8 to 16 years with Gross Motor Function Classification System (GMFCS) levels I-III will be randomly assigned in a 1:1:1 ratio to active tDCS plus VR, sham tDCS plus VR, or conventional physical therapy. Participants will complete 18 treatment sessions over six weeks, with three sessions per week. Outcomes will be assessed at baseline, after nine treatment sessions, and after 18 treatment sessions. Balance will be evaluated using the Pediatric Balance Scale and Functional Reach Test. Executive functions will be assessed using the Trail Making Test, Stroop Test, and Digit Span. Lower-limb spasticity will be evaluated using the Modified Tardieu Scale.

This randomized controlled trial aimed to evaluate the effectiveness of a Virtual Reality (VR)-mediated gamified rehabilitation program compared with conventional physical therapy in children with spastic diplegic cerebral palsy. Forty-two children aged 7-15 years with Gross Motor Function Classification System (GMFCS) Levels II and III were recruited from Rafsan Neuro Rehab Center, Peshawar. Participants were randomly allocated into two equal groups. The intervention group received VR-based gamified rehabilitation using Xbox Kinect along with physiotherapy, while the control group received conventional physiotherapy only. Both groups completed 18 treatment sessions over six weeks. Outcome measures included the Timed Up and Go Test (TUG), Pediatric Balance Scale (PBS), Trunk Impairment Scale (TIS), and Gross Motor Function Classification System (GMFCS). The findings demonstrated that VR-mediated rehabilitation significantly improved functional mobility, balance, and trunk control compared with conventional therapy. The study concludes that VR-based rehabilitation is an effective, motivating, and clinically useful intervention for children with spastic diplegic cerebral palsy and may improve rehabilitation outcomes and functional independence.

This randomized controlled trial aims to compare the effectiveness of fully immersive Mixed Reality (MR) combined with standard physical therapy versus standard physical therapy alone in improving balance and coordination among adolescents with spastic diplegic cerebral palsy. A total of 40 participants aged 10 to 19 years will be randomly assigned to one of two treatment groups. The intervention will be provided three times per week for eight weeks. Balance and coordination will be assessed before treatment, at four weeks, and after completion of the intervention using validated clinical outcome measures. The findings of this study may help determine whether immersive Mixed Reality can enhance rehabilitation outcomes in adolescents with cerebral palsy.

This study aims to evaluate the effect of sensory walkway training on gait performance in children with spastic diplegic cerebral palsy. Participants will be assigned to a control group receiving conventional physical therapy or an intervention group receiving conventional therapy combined with sensory walkway training. The intervention will be conducted over a defined treatment period.