Effects of Robotic Hand Therapy on Hand Function and Dexterity in Cerebral Palsy

Effects of Robotic Hand Therapy in Comparison to Conventional Therapy on Hand Function and Dexterity in Children With Hemiplegic Cerebral Palsy; a Randomized Controlled Trial

This randomized controlled trial aims to evaluate the effects of robotic hand therapy using the Syrebo E12 soft-robotic glove compared with conventional physiotherapy on hand function and manual dexterity in children with hemiplegic cerebral palsy. Children aged 7-15 years, classified as GMFCS I-III and MACS I-III, will be recruited from multiple rehabilitation centers in Pakistan. Participants will be randomly allocated (1:1) to either robotic therapy or standard physiotherapy, receiving 45-minute sessions, three times per week for 8 weeks.

The primary outcome is functional hand performance measured by the Jebsen-Taylor Hand Function Test (JTHFT). Secondary outcomes include ABILHAND-Kids, Box and Block Test, Nine-Hole Peg Test, grip strength, and qualitative feedback. Assessments will occur at baseline, week 4, week 8, and at a 6-month follow-up. A mixed-effects repeated-measures ANCOVA will be used for analysis following the intention-to-treat principle.

Inclusion Criteria:

• Patients diagnosed with Hemiplegic type of Cerebral palsy
• Age 7 to 15 years
• Ability to understand and follow simple instructions
• Gross Motor Function Classification System (GMFCS) levels I-III (ambulatory)
• Manual Ability Classification system (MACS) I to III
• Stable medical condition (no major changes in medication or therapy in the past 3 months).

Exclusion Criteria:

• Patients with severe cognitive dysfunction.
• Fixed contractures or deformities of the upper limb that would prevent safe use of the robotic device.
• Recent upper limb surgery, botulinum toxin injection, or casting within the past 6 months.
• Uncontrolled epilepsy or other unstable medical conditions.
• Visual or auditory impairments that would interfere with assessment or therapy.