Virtual Reality With Mirror Therapy on Upper Limb Function

The goal of this clinical trial is to address the effect of (Virtual Reality) and (Mirror Therapy) together on upper limb function in hemiplegic Cerebral Palsy children , male or female ranged between 3 to 10 years of age

. The main question of the study is Are there any significant differences between the effects of virtual reality (VR), mirror therapy (MR) and the combined effect of both techniques (VR) and (MR) on upper limb function in hemiplegic CP children?

Participants will be subdevided into three groups A , B ,C Group (A): will receive VR in addition to designed physical therapy program Group (B): will receive MT in addition to designed physical therapy program Group (C): will receive the compound effect of both techniques in addition to designed physical therapy program

Inclusion criteria

• Children will be included in the study if they fulfil the following criteria:

• A medical diagnosis of spastic hemiplegic CP made by pediatric neurologists.
• Children with spasticity grades ranged from 1 to 1+ according to MAS.
• Their age range from 4 to 10 years.
• Children level 1 and level 2 in gross motor functional classification (GMFC 1&2)

Exclusion criteria

• Children will be excluded from the study if:

• They had a permanent deformity (bony or soft tissue contractures).
• Children having visual or auditory defects.
• Children who can not understand verbal commands
• Children who had Botox application to the upper extremity in the past 6 months or had undergone a previous surgical intervention to wrist and hand.