Effect of Coordinative Locomotor Training in Children With Cerebral Palsy (CLT-PHYSIO-CP)

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

Cerebral palsy is a brain disorder that affects how children move their bodies. Children with spastic hemiplegic CP have stiffness on one side of the body, making it hard to walk and balance. This study will test a special exercise program called Coordinative Locomotor Training (CLT). CLT uses running and skating movements to train both arms and legs to work together. The investigator want to see if CLT works better than regular physiotherapy for improving coordination and balance in participants. Half of the children will do CLT, and the other half will do regular exercises. The investogar will measure their balance and walking ability before and after 4 weeks of training.

Study Overview

• Status: Active, not recruiting
• Conditions: Cerebral Palsy; Hemiplegia; Spastic cp
• Intervention / Treatment: Other: Coordinative Locomotor Training; Other: Conventional Physiotherapy

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 3800
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Children aged 8 to 12 years.
• Diagnosed with spastic hemiplegic cerebral palsy.
• GMFCS Level I or II.
• Ability to follow simple verbal instructions.
• Medically stable with no changes in anti-spastic medication in the last 3 months.

Exclusion Criteria:

• Orthopedic surgery or Botulinum toxin injection in the last 6 months.
• Severe cognitive impairment preventing cooperation.
• Visual or vestibular deficits affecting balance.
• Uncontrolled seizures.
• Other neurological or musculoskeletal disorders unrelated to CP.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Coordinative Locomotor Training (CLT); PNF-based sprinter and skater patterns in supine, sitting, and standing.	Other: Coordinative Locomotor Training; Participants perform PNF sprinter pattern (flexion/adduction/external rotation on one side with extension/abduction/internal rotation on the opposite side) and skater pattern (reciprocal upper and lower limb movements). Exercises are done for 3 sets of 5 reps, 10-sec holds, 30 min/session, 3x/week for 4 weeks.
Active Comparator: Conventional Physiotherapy (CPT); ROM exercises, stretching, and resistance training.	Other: Conventional Physiotherapy; rotational exercises (5 min), then passive stretching of hamstrings, quadriceps, and ankle plantarflexors combined with resistance training using elastic bands (15 min).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Interlimb Coordination	Measured by 1-step time asymmetry (NAI) during gait analysis.	Baseline (Week 0) and Post-intervention (Week 8)
Change in Dynamic Balance	Measured by the Pediatric Balance Scale (PBS). A 14-item scale scoring from 0 to 56. Higher scores indicate better balance.	Baseline (Week 0) and Post-intervention (Week 8)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Functional Gait Speed	Measured by the Time Up and Go (TUG) test in seconds,	Baseline (Week 0) and Post-intervention (Week 8)

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2026
• Primary Completion (Estimated): June 15, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: June 8, 2026
• First Submitted That Met QC Criteria: June 14, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 14, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Physiotherapy; Spastic Hemiplegia; PNF; Coordinative Locomotor Training; Pediatric Balance
• Additional Relevant MeSH Terms: Neurologic Manifestations; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Paralysis; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Cerebral Palsy; Hemiplegia
• Other Study ID Numbers: TUF/EIRB/ 199 /26

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