The goal of this feasibility study is to evaluate the adherence, parental experiences, and perceptions of a home-based Intensive Segmental Trunk Training (ISTT) program for children aged 4-12 with spastic diplegic cerebral palsy (CP) in Pakistan. The main questions it aims to answer are:
What is the rate of caregiver adherence to a home-based ISTT program over 12 weeks? What are the primary barriers, experiences, and perceptions of caregivers implementing the program? What are the preliminary signals of clinical effectiveness on trunk control and gross motor function? Researchers will compare pre- and post-intervention outcomes (baseline vs. week 12) to see if there are statistically significant improvements in trunk control (measured by SATCo) and gross motor function (measured by GMFM-88).
Participants (20 primary caregivers and their children) will:
Attend an initial in-person orientation session to learn trunk stabilization exercises from a senior pediatric physical therapist Complete a 12-week home-based ISTT program with weekly tele-supervision video calls to monitor progress and address challenges Attend monthly face-to-face monitoring visits at the hospital for clinical assessment and technique reinforcement Complete a KABA (Knowledge, Attitudes, Barriers, and Adherence) survey at baseline and week 12 Participate in a semi-structured interview at the end of the 12-week program to share their experiences.
Inclusion Criteria:
Exclusion Criteria:
This was an open-label, single-arm feasibility study with no blinding. All participants (caregivers and their children), the care provider (pediatric physical therapist conducting tele-supervision), and the investigator assessing outcomes were aware of the intervention assignment, as the study was designed to evaluate real-world feasibility and caregiver experiences with a home-based program.
All 20 caregiver-child dyads received a 12-week home-based Intensive Segmental Trunk Training (ISTT) program. The intervention included an initial in-person orientation session, daily home-based trunk stabilization exercises guided by pre-recorded instructional videos and a picture-based manual, weekly tele-supervision video calls with a pediatric physical therapist, and monthly face-to-face monitoring visits at the hospital. No control, placebo, or sham comparator arm was included in this feasibility study.
Lahore, Punjab Province 54000, Pakistan