Telerehabilitation Compared With Clinic-Based Physiotherapy in Children With Spastic Cerebral Palsy

This randomized controlled trial will compare structured telerehabilitation with clinic-based physiotherapy in children aged 4-12 years with spastic cerebral palsy. Both groups will receive physiotherapy three times per week for 12 weeks. The study will evaluate changes in gross motor function using the Gross Motor Function Measure (GMFM-88), assess spasticity using the Modified Ashworth Scale (MAS), and examine the usability of telerehabilitation using the Telehealth Usability Questionnaire (TUQ). The study aims to determine whether structured telerehabilitation can provide an effective alternative to clinic-based physiotherapy while potentially reducing barriers related to travel, cost, and access to pediatric rehabilitation services.

Inclusion Criteria: 1. Children aged 4-12 years diagnosed with spastic cerebral palsy. 2. Children classified at Gross Motor Function Classification System (GMFCS) levels I-III. 3. Medically stable children able to participate in physiotherapy sessions. 4. Availability of caregiver support and internet access sufficient to participate in telerehabilitation sessions. 5. Written informed consent provided by a parent or legal guardian. Exclusion Criteria: 1. Children without adequate internet access or caregiver support required for telerehabilitation. 2. Children with uncontrolled seizures or severe comorbidities that interfere with safe participation in physiotherapy. 3. Children classified at GMFCS levels IV-V. 4. Children who have undergone orthopedic surgery or received botulinum toxin injections within the preceding 6 months.