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

Cerebral Palsy Spastic Diplegia

Neurodevelopmental Therapy, Play Based Therapy, Spastic diplegic cerebral palsy, Fine motor skills, Spasticity, 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. 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.

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