Action Observation Versus Mirror Therapy in Children With Spastic Hemiplegic Cerebral Palsy

The goal of this clinical trial is to compare the effects of Action Observation therapy and Mirror therapy on hand grip strength and upper extremity function in children with hemiplegic cerebral palsy. Participants will be randomly assigned into two study groups of equal numbers: A group will receive traditional physical therapy program followed by mirror therapy protocol 3 times/ week for 12 weeks. Another group will receive the same traditional physical therapy program in addition exercises using action observation therapy, 3 times/week for 12 weeks. Then, the effect of both treatments will be compared between the two groups.

Inclusion Criteria: * 1- Children diagnosed with spastic hemiplegic CP. 2- Their ages between 5-10 years. 3- Lack of use of the affected upper limb. 4- They will be at level II-III of the Manual Ability Classification System (MACS) 5- The will be at level I-II in the Gross Motor Function Classification System (GMFCS) 6- They will be graded 1 to 1+ in the affected U.L. on Modified Ashworth's Scale 7- The children should be capable of understanding and following instructions. Exclusion Criteria: 1. The children will be excluded if they have one of the following: 2. Children with fixed contracture in the affected U.L. 3. Injection of botulinum toxin into the upper limb muscles during the previous 6 months. 4. Visual or Auditory disorders. 5. Upper limb surgery in the last one year. 6. Epilepsy.