Participants in this group will receive:

• physiotherapy program without massage therapy.

• The physiotherapy program will include the following 10 exercises:

  1. Passive quadriceps stretch
  2. Active-assisted heel slides
  3. Seated knee extensions
  4. Bridging exercise
  5. Straight leg raises
  6. Wall slides (mini-squats)
  7. Low platform step-up training
  8. Sit-to-stand practice
  9. Balance training (in place and on single leg)
  10. Parallel bar gait training

The participants will receive Deep Friction Massage (DFM) Placed over-the-quadriceps muscle fibers with a standardized therapeutic exercise program including:

1. Quadriceps stretch positioning.
2. Active-assisted heel slides
3. Seated knee extensions
4. Bridging exercises
5. Straight leg raises
6. Wall slides (mini-squats)
7. The step-up low platform training.
8. Sit-to-stand training
9. Training on static and dynamic balance.
10. Parallel bar gait training also provided with a standardized therapeutic exercise program including:

1. Quadriceps stretch positioning. 2. Active-assisted heel slides 3. Seated knee extensions 4. Bridging exercises 5. Straight leg raises 6. Wall slides (mini-squats) 7. The step-up low platform training. 8. Sit-to-stand training 9. Training on static and dynamic balance. 10. Parallel bar gait training

DFM Placed over-the-quadriceps muscle fibers to reduce the spasticity

This is a scale used to assess resistance to passive muscle stretch with a scale of 0 to 4 with a 1+ category. Increased scores depict increased spasticity.

Measured with the motor domain of Fugl-Meyer Assessment. This tests voluntary movement, reflex movement and coordination and the higher the scores of the movements, the better the motor performance.