Effect of Task-oriented training based on neurodevelopment therapy principle on gait and functional activities of daily living in cerebral palsy

Cerebral palsy (CP) is a group of non-progressive motor disorders caused by damage to the developing brain, primarily affecting movement and posture(1). It is one of the most common physical disabilities affecting children worldwide, with a prevalence of approximately 2.11 per 1000 live births(2). Children with cerebral palsy often experience significant impairments in gait, leading to decreased functional independence and reduced quality of life. Gait abnormalities in CP can manifest as alterations in stride length, step width, velocity, and overall gait pattern(3,4).

 Cerebral palsy is a complex and heterogeneous neurological condition that affects movement and posture. It is caused by abnormal brain development or damage to the brain, occurring either during pregnancy, childbirth, or the early years of life(5). This non-progressive disorder manifests in various motor impairments, including muscle stiffness, involuntary movements, muscle weakness, and coordination difficulties. Individuals with cerebral palsy may also experience associated conditions, such as intellectual disabilities, epilepsy, communication challenges, and sensory impairments(6). The severity of the condition can vary significantly from person to person, with some individuals being mildly affected, while others may have more severe and profound impairments(7).

 The four main types of cerebral palsy are spastic, dyskinetic, ataxic, and mixed, each characterized by specific movement patterns and affected body parts. Spastic cerebral palsy, the most common type, is marked by increased muscle tone and stiffness, leading to limited joint movement and muscle control(8). Dyskinetic cerebral palsy involves uncontrollable and involuntary movements, affecting both gross and fine motor skills. Ataxic cerebral palsy results in problems with balance and coordination, leading to shaky movements and difficulty performing precise motor tasks. Mixed cerebral palsy is a combination of two or more types of movement disorders, resulting in a wide range of symptoms and challenges.

 The exact cause of cerebral palsy remains unclear in many cases, although several risk factors have been identified. These include premature birth, low birth weight, multiple pregnancies, maternal infections during pregnancy, and brain injuries from oxygen deprivation during childbirth. Early diagnosis and intervention are crucial for managing cerebral palsy effectively. Therapeutic approaches like physical therapy, occupational therapy, and speech therapy aim to improve mobility, motor skills, and communication abilities. Medications may also be prescribed to manage spasticity, alleviate pain, or control associated conditions like seizures. In more severe cases, surgical interventions might be necessary to address specific orthopaedic issues