Effects of Robotic Gait, Hydrotherapy, and Conventional Physiotherapy in Spastic Hemiparetic CP

Spastik Hemiparetik Serebral Palsili Bireylerde Robotik Destekli Yürüyüş Eğitimi, Hidroterapi ve Konvansiyoel Fizyoterapi Yöntemlerinin Kas Kuvveti, Denge, Fonksiyonel Mobilite ve Ruhsal Uyum Üzerindeki Etkileri

This study aims to evaluate the effects of three different physiotherapy approaches-robot-assisted gait training, hydrotherapy, and conventional physiotherapy-on muscle strength, balance, functional mobility, and psychological adjustment in children diagnosed with spastic hemiparetic cerebral palsy. A total of 45 ambulatory children aged 5 to 15 years will be randomly assigned to one of the three intervention groups. All participants will receive therapy twice a week for six weeks.

Muscle strength will be assessed using a handheld dynamometer, balance with the Pediatric Balance Scale, mobility with the Timed Up and Go test, and psychological adjustment with a standardized behavioral checklist. The study will help determine which therapeutic approach provides the most benefit in improving physical function and emotional well-being. Results may guide healthcare providers and families in selecting the most effective rehabilitation method for children with cerebral palsy.

Inclusion Criteria:

• Children aged between 5 and 15 years
• Diagnosed with spastic hemiparetic cerebral palsy
• Classified as Level I or II on the Gross Motor Function Classification System (GMFCS)
• Able to follow simple instructions and participate in therapy sessions
• Written informed consent obtained from parents or legal guardians

Exclusion Criteria:

• Severe cognitive or mental impairment that interferes with communication
• Lower extremity joint contractures preventing use of robotic gait device
• Uncontrolled cardiac disease
• Active infection at the time of intervention
• Open skin lesions on the legs or trunk
• Inability to properly fit orthoses required for therapy
• Withdrawal of consent by the child or parent/guardian
• Failure to complete the assessment tests
• New illness or surgical intervention during the study period