Effect of Coordinative Locomotor Training as Compared to Conventional Physio Therapy in Improving Interlimb Coordination and Dynamic Balance Among Children With Spastic Hemiplegic Cerebral Palsy

This is a double-blinded, parallel-group, randomized controlled trial conducted at the Department of Rehabilitation Sciences, The University of Faisalabad. A total of 38 children diagnosed with spastic hemiplegic cerebral palsy (GMFCS Level I-II), aged 8 to 12 years, will be recruited from pediatric physiotherapy centers. Participants will be randomly assigned (1:1 ratio) using a computer-generated randomization list to either the Experimental Group (CLT) or the Control Group (CPT). The Experimental Group (n=19) will receive Coordinative Locomotor Training based on Proprioceptive Neuromuscular Facilitation (PNF) sprinter and skater patterns. The intervention will be delivered in three postures (supine, sitting, and single-leg stand) for 3 sets of 5 repetitions with a 10-second hold and 10-second rest, lasting 30 minutes per session, 3 times per week for 4 weeks (total 12 sessions). The Control Group (n=19) will receive conventional physiotherapy consisting of hot pack application for 10 minutes, rotational exercises for 5 minutes, followed by stretching and resistance training for 15 minutes, lasting 30 minutes per session, 3 times per week for 4 weeks (total 12 sessions). The primary outcome measures are interlimb coordination (assessed via 1-step time asymmetry and stride time variability) and dynamic balance (Pediatric Balance Scale). Secondary outcomes include functional gait (TUG and 10MWT) and static balance (one-leg stand test).Participants will not know whether they are in experiment or control group. A blinded assessor will evaluate all participants at baseline (Week 0) and post-intervention (Week 8). Data will be analyzed using SPSS version 23.