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Action Observation Therapy in Children With Spastic Diplegia (AOT/CP)

11 de junho de 2026 atualizado por: Esraa Elsayed Ali Hassan Elkiky, Cairo University

Effect of Live Versus Video Action Observation Training on Balance and Gait in Children With Spastic Diplegia

The aim of this study is to compare the effect of live versus video action observation training (AOT) on balance and gait in children with spastic diplegia.

Visão geral do estudo

Descrição detalhada

Children with spastic diplegic often face difficulties with balance and walking, affecting their independence and quality of life. Because of the impact of reduced gait speed and other gait abnormalities on their participation and quality of life, the main focus of physical therapy interventions is to improve balance and gait of children with cerebral palsy (CP).

Action observation training is a developing rehabilitation based on mirror neurons that activate when one performs movements or observes the movements of others. It is applied to improve motor skills and learning in athletes, healthy people, and patients with motor disorders.

Although many studies have focused on the application of action observation training (AOT), especially in improving upper limb function in individuals with stroke or children with CP, there is still a lack of sufficient research examining its effects on spasticity, gross motor abilities, balance, and gait in children with CP.

There is one study comparing the effects of live and video forms of AOT on upper limb function in children with hemiparetic CP. The researchers found that live AOT was more effective than video AOT in improving upper limb performance.

To our knowledge, there are no previous studies that compare the effect of live and video forms of AOT on balance and gait in children with spastic diplegia. Addressing this gap may provide valuable insights into the optimal mode of AOT delivery for enhancing balance and gait.

Tipo de estudo

Intervencional

Inscrição (Estimado)

45

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

  • Nome: Mai Elsayed Abbass, PhD

Locais de estudo

      • Giza, Egito, 12511
        • Outpatient clinic of the Faculty of physical therapy, Cairo University
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Filho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Children of diplegia who walk by a crouch gait.
  • The age of the selected children will range from 4 to 7 years old.
  • Degree of spasticity will range from 1 to 1+, according to modified Ashworth scale (MAS).
  • They will be selected as Level II according to Gross motor function classification system (GMFCS).
  • They will be able to understand the tasks and researchers' instructions.
  • Their heights are not less than 1 meter to be able to see the screen of the Biodex balance system.

Exclusion Criteria:

  • Visual or auditory impairments.
  • Vestibular impairments.
  • Fixed deformities of the upper, lower limbs, and the spine.
  • Botulinum toxin (Botox) injection for the last six months.
  • Orthopedic surgeries in the last six months.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: A selected physical therapy program
Fifteen children will receive one hour of a selected physical therapy program, three times per week for 3 months.
Participants will receive a conventional physical therapy program, 3 sessions per week for 3 months. The program will include approximation exercises, balance training, functional activities (sit-to-stand, squatting, stair climbing), gait training with obstacles, walking exercises on different surfaces, and stretching exercises for the upper and lower limbs. The intervention aims to improve balance, mobility, coordination, and functional performance.
Experimental: A selected physical therapy program + Live action observation training (AOT)
Fifteen children will receive 30 minutes of the same selected physical therapy program plus 30 minutes of live AOT, three times per week for 3 months.
Participants will receive a conventional physical therapy program, 3 sessions per week for 3 months. The program will include approximation exercises, balance training, functional activities (sit-to-stand, squatting, stair climbing), gait training with obstacles, walking exercises on different surfaces, and stretching exercises for the upper and lower limbs. The intervention aims to improve balance, mobility, coordination, and functional performance.
Participants will receive live AOT for 30 minutes, 3 times per week, for 3 months. Each task will involve 3 minutes of observing the therapist performing the activity, followed by 3 minutes of verbal guidance and 3 minutes of task execution by the child. A 1-minute rest period will be provided between tasks.
Experimental: A selected physical therapy program + Video action observation training (AOT)
Fifteen children will receive 30 minutes of the same selected physical therapy program plus 30 minutes of video AOT, three times per week for 3 months.
Participants will receive a conventional physical therapy program, 3 sessions per week for 3 months. The program will include approximation exercises, balance training, functional activities (sit-to-stand, squatting, stair climbing), gait training with obstacles, walking exercises on different surfaces, and stretching exercises for the upper and lower limbs. The intervention aims to improve balance, mobility, coordination, and functional performance.
Participants will receive video-based AOT for 30 minutes, 3 times per week, for 3 months. They will observe task demonstrations presented on a computer screen from multiple viewing angles, followed by guided practice and task performance, similar to the live AOT protocol.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Overall Stability Index (OSI)
Prazo: 3 months
It will be assessed using the Biodex Balance System. Participants will stand on a dynamic platform at stability level 5 for three 30-second trials. The Overall Stability Index (OSI) will be recorded as a measure of postural stability in all directions. Lower OSI values indicate better balance control and greater postural stability.
3 months
Anteroposterior Stability Index (APSI)
Prazo: 3 months
It will be measured using the Biodex Balance System during dynamic balance testing. APSI reflects the participant's ability to maintain balance in the forward and backward directions. Lower APSI scores indicate improved anteroposterior postural control.
3 months
Mediolateral Stability Index (MLSI)
Prazo: 3 months
It will be assessed using the Biodex Balance System. MLSI evaluates the participant's ability to control balance in the side-to-side direction during dynamic standing. Lower MLSI values indicate better mediolateral stability and balance performance.
3 months

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Hip Flexion Angle
Prazo: 3 months
It will be assessed using Kinovea motion analysis software during gait. Reflective markers will be placed on anatomical landmarks, and participants will walk at a self-selected speed while being recorded with a high-definition camera. Hip flexion will be measured during the late swing phase, corresponding to peak hip flexion. Greater hip flexion angles toward normative values will indicate improved gait kinematics.
3 months
Knee Flexion Angle
Prazo: 3 months
It will be evaluated using Kinovea software from recorded gait videos. Anatomical markers will be positioned on the greater trochanter, lateral femoral condyle, and lateral malleolus. Knee flexion will be measured during the terminal stance phase. Changes toward normal knee kinematics will be considered indicative of gait improvement.
3 months
Ankle Dorsiflexion Angle
Prazo: 3 months
It will be measured using Kinovea software during gait analysis. Reflective markers placed on the lower limb and foot will be used to calculate ankle joint kinematics. Ankle dorsiflexion will be assessed at initial contact. Increased dorsiflexion toward normal gait values will indicate improved gait performance.
3 months

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Cadeira de estudo: Eman Ibrahem El-Hadidy, PhD, Professor, Cairo university
  • Diretor de estudo: Mai Elsayed Abbass, PhD, Ass. Professor, Cairo university

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

20 de junho de 2026

Conclusão Primária (Estimado)

20 de setembro de 2026

Conclusão do estudo (Estimado)

30 de setembro de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

11 de junho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

11 de junho de 2026

Primeira postagem (Real)

16 de junho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

16 de junho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

11 de junho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • P.T.REC/012/006208

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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