Forward Versus Backward Gait Training on Functional Abilities in Children With Spastic Cerebral Palsy

This study aims to compare the effects of forward versus backward gait training on functional abilities in children with spastic cerebral palsy. Participants will receive gait training sessions focusing on either forward or backward walking to evaluate improvements in balance, mobility, and gross motor function.

Study Overview

• Status: Completed
• Conditions: Spastic Cerebral Palsy
• Intervention / Treatment: Behavioral: control group ( designed physical therapy program); Behavioral: forward gait training; Behavioral: backward gait training

Detailed Description

> Cerebral palsy is a common neurological disorder in children that affects movement and posture. Spastic cerebral palsy is characterized by muscle stiffness and impaired motor control, which limits the child's functional mobility.

Gait training is an essential part of rehabilitation programs for children with cerebral palsy. Previous studies have shown that both forward and backward walking can improve motor performance, but limited evidence exists comparing the two methods directly.

The present randomized clinical trial aims to compare the effects of forward gait training versus backward gait training on functional abilities in children with spastic cerebral palsy. Participants will be randomly assigned into three groups: group (A) will receive a designed physical therapy program. group (B) will receive the same program with forward gait training on treadmill. group (C) will receive the same designed physical therapy program beside backward gait training on treadmill three times weekly over three successive months.

Outcome measures will include muscle strength of measurements, range of motion of lower limb,gait pattern changes and gross motor function measurements.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Monoufia
    • Shibīn al Kawm, Monoufia, Egypt
      • El Shohadaa Central Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:1-All children will be spastic diplegic cerebral palsy. 2- Age will be ranged from 6-9 years old. 3. They will have spasticity grade 1 to 1+ according to Modified Ashwarth's Scale (Appendix II).

4. Both genders will be included. 5. Their gross motor function ability will be selected at level I, II according to Gross Motor Function Classification System (GMFCS).

6. They will be able to understand and follow verbal commands included in evaluation and training.

Exclusion Criteria:

1- Any surgical intervention in upper or lower limbs. 2¬- Any type of fracture. 3- Visual and/or auditory defects. 4- Other neurological conditions rather than CP. 5- Significant tightness or fixed deformity of lower limbs and spine. 6- Congenital heart disease.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: control group (designed physical therapy program); participants will receive designed physical therapy exercises only	Behavioral: control group ( designed physical therapy program); Participants receive traditional physical therapy exercises focusing on stretching, strengthening, and balance training for the same duration as the experimental groups.
Experimental: forward gait training; participants will receive designed physical therapy exercises beside forward gait training.	Behavioral: forward gait training; The training program consists of forward walking exercises conducted three times per week for three successive months under the supervision of a physical therapist.
Experimental: backward gait training; participants will receive designed physical therapy exercises beside backward gait training.	Behavioral: backward gait training; The training program consists of backward walking exercises conducted three times per week for three successive months under the supervision of a physical therapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gross Motor Function Measure (GMFM-88) score	The GMFM-88 will be used to assess changes in gross motor function in children with spastic cerebral palsy before and after the intervention. Higher scores indicate better motor performance.	Baseline and after three months of intervention

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: Ramy A Khidr, PhD, El Shohadaa Central Hospital

Publications and helpful links

General Publications

• Keep H, Luu L, Berson A, Garland SJ. Validity of the Handheld Dynamometer Compared with an Isokinetic Dynamometer in Measuring Peak Hip Extension Strength. Physiother Can. 2016;68(1):15-22. doi: 10.3138/ptc.2014-62.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2025
• Primary Completion (Actual): February 1, 2026
• Study Completion (Actual): March 1, 2026

Study Registration Dates

• First Submitted: November 19, 2025
• First Submitted That Met QC Criteria: November 19, 2025
• First Posted (Actual): November 26, 2025

Study Record Updates

• Last Update Posted (Actual): March 19, 2026
• Last Update Submitted That Met QC Criteria: March 17, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Gait Training
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Cerebral Palsy; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Research Design; Methods; Control Groups
• Other Study ID Numbers: Ramy Gait training in C.P

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared because the study is conducted locally for academic and clinical purposes only.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No