Bimanual Training Versus Unilateral Task Specific Training in Children With Spastic Hemiplegic Cerebral Palsy

Summary

Cerebral palsy is one of the most common childhood neurological disorders and often results in weakness, poor coordination, and stiffness (spasticity) in one side of the body in children with spastic hemiplegic cerebral palsy. These difficulties can significantly affect a child's ability to perform daily activities such as dressing, eating, playing, and school-related tasks.

Upper limb rehabilitation plays a crucial role in improving independence and quality of life in these children. Two commonly used rehabilitation approaches are bimanual training, which focuses on using both hands together during functional tasks, and unilateral task-specific training, which focuses intensively on improving the affected hand through repetitive, goal-directed activities.

Although both approaches are widely practiced in pediatric neurorehabilitation, there is limited direct comparison of their effectiveness in reducing spasticity and improving functional independence among children with spastic hemiplegic cerebral palsy, particularly in the local population of Pakistan.

This randomized controlled trial aims to compare the effectiveness of bimanual training versus unilateral task-specific training in children aged 5-12 years diagnosed with spastic hemiplegic cerebral palsy. A total of 46 participants will be randomly assigned to one of two intervention groups. Both groups will receive therapy three times per week for eight weeks.

Spasticity will be measured using the Modified Ashworth Scale (MAS), and functional independence will be assessed using the Pediatric Evaluation of Disability Inventory (PEDI). Assessments will be conducted before and after the intervention period.

The results of this study may help clinicians, caregivers, and rehabilitation centers determine which therapy approach is more effective in improving upper limb function and independence in children with spastic hemiplegic cerebral palsy. Participation in this study is voluntary, and children may withdraw at any time without affecting their standard care.

Conditions

• Spastic Cerebral Palsy (sCP)

Interventions

BEHAVIORAL

Bimanual Training

Bimanual training is a structured, task-oriented upper limb rehabilitation program designed to promote coordinated use of both hands during functional, goal-directed activities. The intervention emphasizes active involvement of the affected upper limb within bilateral tasks rather than isolating it. Therapy will be delivered three sessions per week for 8 weeks, with each session lasting 60 minutes. Each session will consist of three 20-minute activity blocks with 5-minute rest intervals to reduce fatigue. Activities will include age-appropriate, real-life bilateral tasks such as buttoning shirts, folding clothes, opening containers, building with blocks, drawing with both hands, catching and throwing balls, and interactive bimanual play tasks. Task complexity will be progressively increased based on the child's tolerance and performance. Unlike unilateral training, this approach focuses on improving interlimb coordination, motor planning, and functional integration of both upper limb

BEHAVIORAL

Unilateral Task-Specific Training

Unilateral Task-Specific Training

Sponsors & Collaborators

• Montiha Azeem

  lead OTHER

Principal Investigators

• Muhammad Hasnain Soomro, MSPTN · The University of Lahore, Lahore

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

5 Years

Max Age

15 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-03-01

Primary Completion

2026-03-01

Completion

2026-05-02

Countries

• Pakistan

Study Locations