Effect of Lower Extremity Modified Constraint-induced Movement Therapy on Locomotion in Children With Hemiplegia

Children with spastic hemiplegic cerebral palsy experience longer gait cycles, slower walking speeds, and longer support phases compared to healthy children, with substantial joint angle differences noted during ground contact and stride buffering. Although most can achieve independent walking, they often exhibit poor motor coordination, resulting in short strides and high stride frequencies for speed maintenance. Modified constraint-induced movement therapy has been employed to enhance lower-extremity function, but its effectiveness on key ambulation aspects like gait speed and balance remains unclear. The reliance on the unaffected limb further impacts locomotive behavior, leading to stiff knee gait and reduced functional mobility. This study aims to explore the therapy's effects on locomotion in hemiplegic children.

Inclusion criteria

• The age of the selected children will range from 6 to 8 years old.
• Degree of spasticity will range from 1+ to 2 according to the modified Ashworth scale.
• The level of motor function of the children will be levels I-II according to the Gross Motor Function Classification System.
• Participants will present a score between 41 to 56 points on the pediatric balance scale.
• They will be able to follow instructions and understand commands.

Exclusion criteria

• Bone and tendon lengthening surgeries within the last 6 months.
• Lung and heart diseases and disorders.
• Vision or hearing problems.
• Children with fixed deformities in the lower extremity.
• Children with epilepsy.
• Recent intramuscular Botulinum toxin injection.