IMPACT OF PROGRESSIVE STRENGTH AND FUNCTIONAL TASK-ORIENTED TRAINING ON MOBILITY AND GROSS MOTOR FUNCTION IN CHILDREN WITH SPASTIC CEREBRAL PALSY: A QUASI-EXPERIMENTAL STUDY

Background: Spastic diplegic cerebral palsy is characterized by muscle weakness, impaired motor control, and balance deficits that limit mobility and functional independence. Although progressive strength training and task-oriented rehabilitation have demonstrated benefits independently, evidence evaluating their combined effect within structured pediatric rehabilitation programs remains limited, particularly in Pakistani clinical settings. Objective: To evaluate the effects of combined progressive strength and task-oriented training on mobility, balance, gait speed, and function in children. Methods: A quasi-experimental single-group pretest–posttest study was conducted in a hospital-based pediatric rehabilitation department in KP. 28 children aged 5–12 years with spastic diplegic cerebral palsy (GMFCS Levels I–III) completed an 8-week individualized intervention combining progressive strength training and functional task-oriented activities delivered three times per week. Outcomes included the Gross Motor Function Measure (GMFM-66), Pediatric Balance Scale (PBS), Timed Up and Go (TUG), and 10-Meter Walk Test (10MWT). Paired t-tests were used to compare pre- and post-intervention scores, and Cohen’s d was calculated to determine effect sizes. Results: Significant improvements were observed across all outcomes following the intervention. GMFM-66 scores improved by 7.6 points (p < 0.001), indicating enhanced gross motor function. PBS scores increased significantly (p < 0.001), reflecting improved balance and postural control. Functional mobility improved, with TUG times decreasing significantly (p < 0.001), while gait speed improved as demonstrated by reduced 10MWT completion time (p < 0.001). Effect sizes ranged from moderate to large (d = 0.68–1.21). Intervention adherence averaged 92%, and no adverse events were reported. Conclusion: A combined progressive strength and functional task-oriented training program significantly improves mobility, balance, gait performance, and gross motor function in children with spastic diplegic cerebral palsy. This integrated approach addresses neuromuscular impairments and functional performance limitations, supporting motor learning and functional independence. The intervention is safe, clinically feasible, and well suited for hospital-based pediatric rehabilitation, including resource-limited settings. Further controlled trials are recommended to confirm long-term effectiveness and broader applicability.