Spastic cerebral palsy is a neurological condition that causes muscle spasticity and motor impairments, greatly impacting a child's ability to maintain balance and control their posture. The horse riding simulator (HRS), inspired by hippo therapy, has emerged as a potential therapeutic intervention for enhancing motor function in individuals with cerebral palsy. This study explored the additional effects of mirror visual feedback when used in conjunction with the HRS. Strategically placed mirrors allow participants to observe their own body movements and positions in real-time. The simulator's rhythmic, multidimensional movements deliver sensory input and challenge the motor system, promoting postural adjustments and improved balance. Furthermore, the integration of mirror visual feedback appears to enhance the therapeutic benefits. Real-time visual information enables children to actively observe and correct their body positioning, leading to improved body awareness and more efficient motor responses.

Cerebral palsy (CP), one of the most common physical disabilities in childhood, is a disorder of movement and posture caused by non-progressive lesions in the developing brain. Children with CP, to varying degrees, have muscle weakness, tone abnormality, and motor-control impairment, causing abnormal posture and poor balance control.In high-income countries, the current birth prevalence of cerebral palsy has decreased to 1.6 per 1000 live births. However, in low- and middle-income countries, the birth prevalence is significantly higher. Children diagnosed with CP exhibit a range of muscle weakness, tone abnormalities, and impaired motor control. These factors contribute to abnormal posture and compromised control over balance

Inclusion Criteria:

• Spastic cerebral palsy with level I and II according to Gross Motor Function Classification System (GMFCS)
• Age between 8 and 12 years
• Ability to sit and stand independently
• Both genders are included (female and male)

Exclusion Criteria:

• Having received an injection of botulinum toxin within 3 months
• Having undergone orthopedic surgery or selective dorsal rhizotomy in the previous 1 year
• Having undergone HRS training within 6 months;
• Having severe pain, joint dislocation, contracture, or spinal deformity
• Having experienced uncontrolled epileptic seizure
• Having poor visual or hearing acuity.