Comparative Effects of Play-Based Therapy and NDT in Diplegic CP

Overview

To compare the efficacy of play-based therapy versus NDT in improving fine motor skills in children with Spastic Diplegic Cerebral Palsy. Baseline Assessments (Pre-Intervention) To Establish baseline motor function, balance, and goals. * Standardized Tools (Conducted in Week 1): * Peabody Developmental Motor Scales (PDMS-2): Evaluate gross and fine motor skills. * Modified Ashworth Scale: Assess spasticity in lower and upper limbs. * Pediatric Balance Scale (PBS): Measure static and dynamic balance. * Parent/Child Goal Setting: Identify individualized goals (e.g., stair climbing, dressing independence). 1\. Play-Based Therapy (PBT) * 5-Minute Warm-Up: Gentle play (e.g., rolling a ball, stretching with ribbons) * Building Blocks: Focus on fine motor control, bilateral coordination, and problem-solving. * Puzzles: Enhance spatial awareness, grip strength, and cognitive engagement. * Arts and Crafts: Promote hand-eye coordination (e.g., cutting, drawing) and creativity. * Frequency: 4 days a week, for 3 consecutive weeks * Intensity: Moderate effort; tasks tailored to the child's skill level (e.g., 5 piece puzzles progressing to 10-piece). * Time: 45-minute sessions (30 minutes active play, 10 minutes rest/reinforcement). 2. Neurodevelopmental Therapy (NDT) * 5-Minute Warm-Up: Light mobility exercises (e.g., Hand pumps, seated marching). * Resistance Bands: Strengthen upper limbs (e.g. Bicep curls, shoulder abduction, chest presses.). * Small Dumbbells: Improve upper body strength (1-2 lbs for shoulder/arm exercises). * Stress Ball Squeezes: Enhance grip strength and hand function (5-10 reps/session). * Frequency: 4 days a week, for 3 consecutive weeks * Intensity: Moderate resistance; emphasize alignment and controlled movement * Time: 40-minute sessions (30 minutes active exercise, 10 minutes rest/feedback). Outcome Measures * Peabody Developmental Motor Scales (PDMS-2): for evaluating fine motor skills. * Modified Ashworth Scale (MAS): To measure muscle spasticity (tone) in the limbs. * CHQ: To measure health-related quality of life

To compare the efficacy of play-based therapy versus NDT in improving fine motor skills in children with Spastic Diplegic Cerebral Palsy. Inclusion Criteria * Confirmed medical diagnosis of spastic diplegic cerebral palsy by a healthcare professional. * Children aged between 8 to 12 years old (Raipure, Kovela, \& Harjpal, 2023). * Documented difficulties in fine motor skills, assessed by a standardized motor skills evaluation tool. * Ability to understand and follow instructions, with or without assistance, to participate in the therapy sessions. * Written informed consent from parents or legal guardians, allowing the child to participate in the study. Exclusion Criteria * Presence of any other significant medical condition that might interfere * Diagnosis of other forms of cerebral palsy (e.g., hemiplegic, quadriplegic).(Raipure et al., 2023). * Severe cognitive impairments that would prevent understanding or participation in the therapy sessions. * Presence of uncontrolled medical conditions (e.g., severe epilepsy, cardiac conditions) that would pose a risk during physical activity. * Previous extensive therapy for fine motor skills in the past 6 months, which might influence the study outcomes. * Lack of compliance or cooperation from the child or parents/guardians during a preliminary assessment.(Raipure et al., 2023). All participants will be given the intervention for 45 minutes, 4 days a week, for 3 consecutive weeks.