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The goal of this observational study is to develop and validate an AI-based prediction model for functional mobility and gait outcomes in children with cerebral palsy using low-cost clinical and gait data collected in rehabilitation settings in Pakistan. The study aims to determine whether machine learning models can accurately predict mobility status, gait symmetry, and functional independence in ambulatory and non-ambulatory children with cerebral palsy.
The main questions it aims to answer are:
Researchers will analyze clinical, functional, and gait data to identify patterns associated with mobility limitations and rehabilitation outcomes.
Participants will:
Children with cerebral palsy (CP) commonly experience limitations in functional independence and mobility, which significantly affect participation and quality of life. Accurate assessment of these functional abilities is essential for rehabilitation planning, prognosis estimation, and monitoring treatment outcomes. However, conventional assessment methods largely depend on therapist observation and standardized clinical scales, which may be subjective, time-consuming, and less sensitive to complex interactions among clinical variables. In low-resource rehabilitation settings, the limited availability of advanced assessment technologies further restricts objective and data-driven clinical decision-making. Therefore, there is a growing need for innovative, accessible, and reliable approaches to improve rehabilitation assessment in children with CP.
The novelty of this study lies in the application of machine learning techniques to rehabilitation assessment of functional independence and mobility in children with cerebral palsy. Unlike traditional approaches that rely solely on isolated clinical interpretation, this study aims to integrate multiple clinical and functional parameters to identify predictive patterns associated with mobility and independence outcomes. The proposed approach introduces a data-driven and potentially more objective framework for rehabilitation assessment, supporting early identification of functional limitations and personalized intervention planning. Additionally, conducting this research in a low-resource context contributes further novelty by exploring the feasibility of implementing machine learning-based rehabilitation assessment tools in settings where advanced gait laboratories and expensive technologies are not readily available.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ambulatory Children with Spastic Cerebral Palsy (GMFCS I-III) | Children diagnosed with spastic cerebral palsy who are ambulatory and classified within Gross Motor Function Classification System (GMFCS) Levels I to III. Participants will undergo clinical, functional, and gait assessments for AI-based prediction of functional mobility and gait outcomes |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AI-Based Functional Mobility and Gait Assessment | Other | Participants will continue receiving their standard/routine physiotherapy rehabilitation program as prescribed by their treating therapist. The study will involve observational collection of clinical, functional, and gait-related data using standardized assessment tools, and AI-based video analysis. No additional therapeutic intervention will be administered specifically for research purposes. |
| Measure | Description | Time Frame |
|---|---|---|
| GMFM-88 | GMFM (Gross Motor Function Measure) Reliability: Excellent. Internal consistency Cronbach's α ~0.997-1.00; intra- and inter-rater ICC ~0.994-0.999 (both GMFM-88 & GMFM-66) Validity: Construct and concurrent validity supported by strong correlations with related motor function classifications (e.g., GMFCS, PEDI mobility) | Baseline to 6 months followup |
| Markerless Gait Analysis | Gait videos will be processed using a validated markerless pose estimation framework (MediaPipe) Spatiotemporal and kinematic gait parameters will be extracted, including but not limited to:
| Baseline to 6 months |
| Edinburgh visual gait scale (EVGS) | Edinburgh visual gait scale (EVGS) EVGS can be a supportive tool that adds quantitative data instead of only qualitative assessment to a video only gait evaluation. Interobserver agreement is 60-90% and Kappa values are 0.18-0.85 for the 17 items in EVGS. Reliability is higher for distal segments (foot/ankle/knee 63-90%; trunk/pelvis/hip 60-76%). Agreement between EVGS and 3DGA is 52-73%. | Baseline to 6 Months |
| WeeFIM (Functional Independence Measure for Children) | WeeFIM (Functional Independence Measure for Children) Reliability: High internal consistency and ICCs (motor and cognitive scales) ~0.91-0.98 in children with cerebral palsy Validity: Construct and external validity supported (scale fits Rasch model expectations and correlates with related developmental measures) | Baseline to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| System usabiity scale (SUS) | 10 items likert scale questionnaire evaluating percieved usability and acceptability | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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Children with cerebral palsy classified within Gross Motor Function Classification System (GMFCS) Levels I-III who are ambulatory with or without assistive devices and receiving routine physiotherapy rehabilitation. Participants from all cerebral palsy subtypes will be included for clinical, functional, and gait assessment related to AI-based evaluation of functional mobility and gait outcomes.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Qamar Mehmood, Phd Rehab | Contact | 03335151063 | qamar.mehmood@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Sidra Ghias, PhD* Rehab | Riphah International university Isalambad | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Alfarabi special education center | Islamabad | Pakistan |
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| Army special education Academy | Islamabad | Pakistan |
| National institute of Rehabilitation medicine | Islamabad | Pakistan |
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| Karachi institue of neurological diseases and rehabilitation(KIND-R) | Karachi | Pakistan |
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