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