The Effectiveness of Neurodevelopmental Treatment (Bobath) and Functional Physiotherapy in Children With Cerebral Palsy.

The Effectiveness of Neurodevelopmental Treatment (Bobath) and Functional Physiotherapy on Upper Arm Strength and Trunk Control in Children With Cerebral Palsy.

Cerebral palsy is one of the most common causes of physical disability in childhood and is often associated with impaired trunk control, reduced upper limb strength, and limitations in functional mobility and daily activities. Trunk control is essential for postural stability and directly influences upper limb function and the ability to perform goal-directed tasks.

Neurodevelopmental Treatment (NDT/Bobath) and functional physiotherapy are widely used approaches in pediatric neurorehabilitation. NDT/Bobath focuses on facilitating postural control and promoting efficient movement patterns, while functional physiotherapy emphasizes task-specific training and the improvement of motor performance through meaningful activities. However, evidence comparing the effectiveness of these approaches on trunk control and upper arm strength remains limited.

This study aims to investigate and compare the effectiveness of Neurodevelopmental Treatment (NDT/Bobath) and functional physiotherapy on upper arm strength and trunk control in children with cerebral palsy. Participants will be allocated to different intervention groups, with each group receiving one of the two therapeutic approaches.

Additionally, wearable Inertial Measurement Units (IMUs) will be used to provide objective and quantitative assessment of trunk movement under both static (sitting) and dynamic (functional movement) conditions.

We hypothesize that both intervention groups will demonstrate improvements in trunk control and upper arm strength, with potential differences in the magnitude of improvement between the two approaches. Furthermore, IMU-based measurements are expected to detect subtle changes in movement quality that may not be captured by traditional clinical assessment tools.

The findings of this study may contribute to a better understanding of the comparative effectiveness of commonly used therapeutic approaches and support evidence-based decision-making in pediatric rehabilitation.

Inclusion Criteria:

• Age 4-12 years
• Diagnosis of Cerebral Palsy
• Ability to understand simple commands (cooperative child)
• Classification in GMFCS (Levels I-IV)
• Physical therapy interventions in Pediatric Physiotherapy Laboratories throughout Greece
• Signed parental consent within one week of notification

Exclusion Criteria:

• Botulinum toxin (Botox) injection within the last 3 months
• Selective dorsal rhizotomy within the last 1 year
• Uncontrolled epilepsy
• Co-existing pathologies affecting the trunk and functionality
• Age outside the range of 4-12 years