Action Observation Therapy in Children With Spastic Diplegia

Effect of Live Versus Video Action Observation Training on Balance and Gait in Children With Spastic Diplegia

The aim of this study is to compare the effect of live versus video action observation training (AOT) on balance and gait in children with spastic diplegia.

Children with spastic diplegic often face difficulties with balance and walking, affecting their independence and quality of life. Because of the impact of reduced gait speed and other gait abnormalities on their participation and quality of life, the main focus of physical therapy interventions is to improve balance and gait of children with cerebral palsy (CP).

Action observation training is a developing rehabilitation based on mirror neurons that activate when one performs movements or observes the movements of others. It is applied to improve motor skills and learning in athletes, healthy people, and patients with motor disorders.

Although many studies have focused on the application of action observation training (AOT), especially in improving upper limb function in individuals with stroke or children with CP, there is still a lack of sufficient research examining its effects on spasticity, gross motor abilities, balance, and gait in children with CP.

There is one study comparing the effects of live and video forms of AOT on upper limb function in children with hemiparetic CP. The researchers found that live AOT was more effective than video AOT in improving upper limb performance.

To our knowledge, there are no previous studies that compare the effect of live and video forms of AOT on balance and gait in children with spastic diplegia. Addressing this gap may provide valuable insights into the optimal mode of AOT delivery for enhancing balance and gait.

Inclusion Criteria:

• Children of diplegia who walk by a crouch gait.
• The age of the selected children will range from 4 to 7 years old.
• Degree of spasticity will range from 1 to 1+, according to modified Ashworth scale (MAS).
• They will be selected as Level II according to Gross motor function classification system (GMFCS).
• They will be able to understand the tasks and researchers' instructions.
• Their heights are not less than 1 meter to be able to see the screen of the Biodex balance system.

Exclusion Criteria:

• Visual or auditory impairments.
• Vestibular impairments.
• Fixed deformities of the upper, lower limbs, and the spine.
• Botulinum toxin (Botox) injection for the last six months.
• Orthopedic surgeries in the last six months.