Comparison of Synchronous and Asynchronous Action Observation Therapy in Children With Cerebral Palsy

The aim of this study is to compare the effects of synchronous and asynchronous action observation therapy (AOT) on balance, gait, and functional capacity in children with cerebral palsy (CP). CP is a neurodevelopmental disorder characterized by impairments in motor skills, particularly motor control and postural balance. By examining the contributions of synchronous (real-time) and asynchronous (delayed) AOT methods to motor performance, this study seeks to identify the most effective therapeutic approach for this population.

Inclusion Criteria: * Voluntary participation of both the child and their family in the study * Diagnosis of cerebral palsy with spastic clinical type, including hemiparetic and diparetic distribution * Age between 6 and 18 years * Classified as Level I or II according to the Gross Motor Function Classification System (GMFCS) * Ability to comply with exercise interventions (based on medical report indicating normal mental level or "mild mental retardation") * Ability to understand and speak Turkish Exclusion Criteria: * Presence of spasticity ≥3 in lower extremity muscle groups as measured by the Modified Ashworth Scale * Inability to cooperate with verbal commands * Presence of visual or hearing impairments * Diagnosis of epilepsy or current use of antiepileptic medications * Presence of joint contractures * Botulinum toxin injection to the lower extremities within the past 6 months * Undergoing orthopedic surgery within the past 6 months * Presence of any additional systemic or neurological diseases * Missing three consecutive rehabilitation sessions