This study evaluates the clinical efficacy of the Strain Counter-Strain (SCS) technique on improving oromotor functions in children with spastic cerebral palsy. The intervention specifically targets the masseter, SCM, upper trapezius, scalenes, and suprahyoid muscles to release myofascial tension. The study aims to determine if modulating muscle tone through SCS can provide a stable postural foundation to enhance functional oral motor skills. Outcomes are measured after 4 weeks (one month) of intervention, focusing on mouth opening range, drooling frequency and severity, and overall oral motor functions

This study follows a Randomized Controlled Trial (RCT) design. Children with spastic cerebral palsy are screened for inclusion based on impaired oromotor control and persistent neck muscle tension.

The Control Group receives a designed oral motor program aimed at improving oral motor functions, mouth opening, and drooling severity, conducted over 4 weeks (one month).

The Study Group receives the same designed oral motor program, preceded by the Strain Counter-Strain (SCS) technique applied to the masseter, sternocleidomastoid (SCM), scalenes, upper trapezius, and suprahyoid muscles. The SCS technique aims to normalize cervical alignment and release restrictive tension in the orofacial region.

Outcome Measures: Functional and physical changes are assessed at baseline and after the 4-week period. The primary outcomes include:

Mouth opening range (measured in centimeters). Drooling frequency and severity (using standardized scales). Oral motor functions (evaluated through standardized scales). The comparison seeks to demonstrate how stabilizing the proximal postural base through SCS facilitates refined distal oromotor performance

Inclusion Criteria:

• Chronological age was 4 - 8 years from gender was selected
• Their degrees of spasticity were 1, 1+ according to modified Ashworth scale.
• They had moderate drooling according to modified drooling questionnaire.
• Mouth opening limitation was less than 3 cm.
• Their levels of motor function were II - III- IV according to gross motor function classification system.
• Their levels of feeding abilities were III on Eating and Drinking Ability Classification System.
• Children were able to follow instruction

Exclusion Criteria:

• Any history of jaw, head, and face trauma.
• Facial or dental developmental abnormalities.
• Any history of head and neck surgical intervention.
• Congenital abnormalities of head and neck

Individual participant data will not be available to protect the privacy and confidentiality of the participants. The study results will be disseminated through the final thesis and potential peer-reviewed publications as aggregate data only

This is an open-label study where both the participants and the investigator are aware of the assigned interventions. Masking was not feasible due to the nature of the manual therapy technique (Strain Counter-Strain) and the active involvement of the physical therapist in administering the protocol.