To compare the efficacy of play-based therapy versus NDT in improving fine motor skills in children with Spastic Diplegic Cerebral Palsy.

Baseline Assessments (Pre-Intervention) To Establish baseline motor function, balance, and goals.

• Standardized Tools (Conducted in Week 1):

• Peabody Developmental Motor Scales (PDMS-2): Evaluate gross and fine motor skills.

• Modified Ashworth Scale: Assess spasticity in lower and upper limbs.

• Pediatric Balance Scale (PBS): Measure static and dynamic balance.

• Parent/Child Goal Setting: Identify individualized goals (e.g., stair climbing, dressing independence).

  1. Play-Based Therapy (PBT)

• 5-Minute Warm-Up: Gentle play (e.g., rolling a ball, stretching with ribbons)

• Building Blocks: Focus on fine motor control, bilateral coordination, and problem-solving.

• Puzzles: Enhance spatial awareness, grip strength, and cognitive engagement.

• Arts and Crafts: Promote hand-eye coordination (e.g., cutting, drawing) and creativity.

• Frequency: 4 days a week, for 3 consecutive weeks

• Intensity: Moderate effort; tasks tailored to the child's skill level (e.g., 5 piece puzzles progressing to 10-piece).

• Time: 45-minute sessions (30 minutes active play, 10 minutes rest/reinforcement). 2. Neurodevelopmental Therapy (NDT)

• 5-Minute Warm-Up: Light mobility exercises (e.g., Hand pumps, seated marching).

• Resistance Bands: Strengthen upper limbs (e.g. Bicep curls, shoulder abduction, chest presses.).

• Small Dumbbells: Improve upper body strength (1-2 lbs for shoulder/arm exercises).

• Stress Ball Squeezes: Enhance grip strength and hand function (5-10 reps/session).

• Frequency: 4 days a week, for 3 consecutive weeks

• Intensity: Moderate resistance; emphasize alignment and controlled movement

• Time: 40-minute sessions (30 minutes active exercise, 10 minutes rest/feedback). Outcome Measures

• Peabody Developmental Motor Scales (PDMS-2): for evaluating fine motor skills.

• Modified Ashworth Scale (MAS): To measure muscle spasticity (tone) in the limbs.

• CHQ: To measure health-related quality of life

To compare the efficacy of play-based therapy versus NDT in improving fine motor skills in children with Spastic Diplegic Cerebral Palsy.

Inclusion Criteria

• Confirmed medical diagnosis of spastic diplegic cerebral palsy by a healthcare professional.
• Children aged between 8 to 12 years old (Raipure, Kovela, & Harjpal, 2023).
• Documented difficulties in fine motor skills, assessed by a standardized motor skills evaluation tool.
• Ability to understand and follow instructions, with or without assistance, to participate in the therapy sessions.
• Written informed consent from parents or legal guardians, allowing the child to participate in the study. Exclusion Criteria
• Presence of any other significant medical condition that might interfere
• Diagnosis of other forms of cerebral palsy (e.g., hemiplegic, quadriplegic).(Raipure et al., 2023).
• Severe cognitive impairments that would prevent understanding or participation in the therapy sessions.
• Presence of uncontrolled medical conditions (e.g., severe epilepsy, cardiac conditions) that would pose a risk during physical activity.
• Previous extensive therapy for fine motor skills in the past 6 months, which might influence the study outcomes.
• Lack of compliance or cooperation from the child or parents/guardians during a preliminary assessment.(Raipure et al., 2023).

All participants will be given the intervention for 45 minutes, 4 days a week, for 3 consecutive weeks.

Inclusion Criteria:

• Confirmed medical diagnosis of spastic diplegic cerebral palsy by a healthcare professional.
• Children aged between 8 to 12 years old.
• Documented difficulties in fine motor skills, assessed by a standardized motor skills evaluation tool.
• Ability to understand and follow instructions, with or without assistance, to participate in the therapy sessions.
• Written informed consent from parents or legal guardians, allowing the child to participate in the study.

Exclusion Criteria:

• Presence of any other significant medical condition that might interfere
• Diagnosis of other forms of cerebral palsy (e.g., hemiplegic, quadriplegic).
• Severe cognitive impairments that would prevent understanding or participation in the therapy sessions.
• Presence of uncontrolled medical conditions (e.g., severe epilepsy, cardiac conditions) that would pose a risk during physical activity.
• Previous extensive therapy for fine motor skills in the past 6 months, which might influence the study outcomes.
• Lack of compliance or cooperation from the child or parents/guardians during a preliminary assessment.