Telerehabilitation Compared With Clinic-Based Physiotherapy in Children With Spastic Cerebral Palsy

November 2, 2026 updated by: Riphah International University

Effectiveness of Structured Telerehabilitation Compared With Clinic-Based Physiotherapy for Improving Gross Motor Functions in Young Children With Spastic Cerebral Palsy

This randomized controlled trial will compare structured telerehabilitation with clinic-based physiotherapy in children aged 4-12 years with spastic cerebral palsy. Both groups will receive physiotherapy three times per week for 12 weeks. The study will evaluate changes in gross motor function using the Gross Motor Function Measure (GMFM-88), assess spasticity using the Modified Ashworth Scale (MAS), and examine the usability of telerehabilitation using the Telehealth Usability Questionnaire (TUQ). The study aims to determine whether structured telerehabilitation can provide an effective alternative to clinic-based physiotherapy while potentially reducing barriers related to travel, cost, and access to pediatric rehabilitation services.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The primary objective of this randomized controlled trial is to compare the effectiveness of structured telerehabilitation and clinic-based physiotherapy in improving gross motor functions among children aged 4-12 years with spastic cerebral palsy classified at Gross Motor Function Classification System (GMFCS) levels I-III. A secondary objective is to assess the usability of structured telerehabilitation using the Telehealth Usability Questionnaire (TUQ). A total of 44 participants will be randomly allocated to two groups, with 22 participants in each group. Both groups will receive physiotherapy three times per week for 12 weeks, with each session lasting approximately 45 minutes. Gross motor function will be assessed using the Gross Motor Function Measure-88 (GMFM-88), while spasticity will be evaluated using the Modified Ashworth Scale (MAS). Assessments will be conducted at baseline, six weeks, and 12 weeks to monitor changes during the intervention period. The study will determine whether structured telerehabilitation can provide comparable improvements in gross motor function to clinic-based physiotherapy and evaluate its usability as an alternative approach to delivering pediatric rehabilitation services.

Study Type

Interventional

Enrollment (Estimated)

44

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Kpk
      • Swābi, Kpk, Pakistan, 23430
        • Recruiting
        • Health and wellness physiotherapy and rehabilitation centre shewa adda swabi

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

4 years to 12 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Children aged 4-12 years diagnosed with spastic cerebral palsy.
  2. Children classified at Gross Motor Function Classification System (GMFCS) levels I-III.
  3. Medically stable children able to participate in physiotherapy sessions.
  4. Availability of caregiver support and internet access sufficient to participate in telerehabilitation sessions.
  5. Written informed consent provided by a parent or legal guardian.

Exclusion Criteria:

  1. Children without adequate internet access or caregiver support required for telerehabilitation.
  2. Children with uncontrolled seizures or severe comorbidities that interfere with safe participation in physiotherapy.
  3. Children classified at GMFCS levels IV-V.
  4. Children who have undergone orthopedic surgery or received botulinum toxin injections within the preceding 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Structured Telerehabilitation

Participants will receive a structured physiotherapy program remotely through video communication, three times per week for 12 weeks, with approximately 45 minutes per session.

A structured physiotherapy program delivered remotely through video communication under physiotherapist guidance, with caregiver assistance. The program will be conducted three times per week for 12 weeks, with each session lasting approximately 45 minutes. Exercises will include stretching, range-of-motion exercises, strengthening, balance training, functional mobility, postural control, and coordination activities tailored to the child's functional abilities.

Active Comparator: Clinic-Based Physiotherapy

Participants will receive a structured physiotherapy program in a clinical setting under direct physiotherapist supervision, three times per week for 12 weeks, with approximately 45 minutes per session.

A structured physiotherapy program delivered in a clinical setting under direct physiotherapist supervision. The program will be conducted three times per week for 12 weeks, with each session lasting approximately 45 minutes. Exercises will include stretching, range-of-motion exercises, strengthening, balance training, functional mobility, postural control, and coordination activities tailored to the child's functional abilities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Gross Motor Function Measure-88 (GMFM-88) Score
Time Frame: Baseline, 6 weeks, and 12 weeks after the start of the intervention.

Gross motor function will be assessed using the Gross Motor Function Measure-88 (GMFM-88), a standardized tool used to evaluate motor abilities in children with cerebral palsy across five dimensions: lying and rolling, sitting, crawling and kneeling, standing, and walking, running, and jumping. Changes in GMFM-88 scores from baseline to the end of the 12-week intervention will be compared between the structured telerehabilitation and clinic-based physiotherapy groups.

Baseline, 6 weeks, and 12 weeks after the start of the intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Modified Ashworth Scale (MAS) Scores
Time Frame: Baseline and 12 weeks after the start of the intervention.

Spasticity will be assessed using the Modified Ashworth Scale (MAS), which measures resistance to passive movement during clinical examination. Changes in MAS scores from baseline to the end of the intervention will be compared between the two study groups.

Baseline and 12 weeks after the start of the intervention.
Usability of the Structured Telerehabilitation Program
Time Frame: At the end of the 12-week intervention.

The usability of the structured telerehabilitation program will be assessed using the Telehealth Usability Questionnaire (TUQ) at the end of the intervention. The questionnaire will evaluate caregivers' perceptions of the usability and acceptability of the telerehabilitation approach.

At the end of the 12-week intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Zobia Naeem, MS, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 21, 2026

Primary Completion (Estimated)

April 5, 2027

Study Completion (Estimated)

April 12, 2027

Study Registration Dates

First Submitted

November 2, 2026

First Submitted That Met QC Criteria

November 2, 2026

First Posted (Actual)

November 6, 2026

Study Record Updates

Last Update Posted (Actual)

November 6, 2026

Last Update Submitted That Met QC Criteria

November 2, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • Adan Nisar

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.