Early Intervention in Cerebral Palsy: Perception-Action vs Neurodevelopmental Therapy

NCT07575659 | Not Yet Recruiting

• 1 other identifier: 2026/55
• Study Type: interventional
• Target: 24
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to compare two different physiotherapy approaches used in early intervention for children with cerebral palsy. These approaches are the Perception-Action Approach and Neurodevelopmental Therapy (Bobath). The study aims to understand which approach is more effective in supporting neurodevelopmental outcomes in early childhood in Cerebral Palsy. The main questions this study aims to answer are: How does the Perception-Action Approach affect motor function in young children with cerebral palsy? How does Neurodevelopmental Therapy (Bobath) affect motor function in young children with cerebral palsy? Are there differences in outcomes between these two approaches? Researchers will compare these two approaches to see which one better supports motor development. Participants will: Be children aged 0 to 36 months with cerebral palsy or at high risk Be assigned to one of the two therapy groups Receive one therapy session per week for 12 weeks Be assessed before and after the intervention using standardized tests The results of this study may help therapists and families choose the most effective early intervention approach for children with cerebral palsy.

Conditions

Cerebral Palsy; Cerebral Palsy Early Intervention

Keywords

Cerebral Palsy; Early Intervention; Pediatric Physiotherapy; Neurodevelopmental Therapy; Bobath Concept; Perception-Action Approach; Neuro-Developmental Treatment (NDT); GMFM-66; Infant Motor Profile; Bayley III; Pediatric Evaluation of Disability Inventory

Outcome Measures

Primary Outcomes (1)

• Gross Motor Function Measure-66 (GMFM-66)

  The GMFM-66 is a standardized observational assessment used to evaluate changes in gross motor function in children with cerebral palsy. It provides interval-level measurement of motor abilities and is sensitive to changes over time.

  Baseline (pre-intervention) and after 12 weeks of intervention

Secondary Outcomes (3)

• Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III)

  Baseline (pre-intervention) and after 12 weeks of intervention

• Infant Motor Profile (IMP)

  Baseline (pre-intervention) and after 12 weeks of intervention

• Pediatric Evaluation of Disability Inventory (PEDI)

  Baseline (pre-intervention) and after 12 weeks of intervention

Other Outcomes (1)

• The Parental Stress Scale (PSS)

  Baseline (pre-intervention) and after 12 weeks of intervention

Study Arms (2)

Perception-Action Approach (PA)

EXPERIMENTAL

The Perception-Action Approach is grounded in ecological, dynamic systems, and neural group selection theories, emphasizing perception-action coupling and supporting the child's overall development through self-initiated actions. The intervention promotes variability, adaptability, and exploration in an enriched environment. Therapists primarily structure the environment to encourage independent discovery of functional solutions rather than using hands-on facilitation. Activities are individualized to support variability, adaptability, and functional problem-solving. Informational touch may be used as task-consistent input to enhance perception of the relationship between the body and environment, inviting new movement possibilities without guiding movement. Variability and adaptability are prioritized over a single ideal movement pattern, and errors are considered part of learning. Sessions are conducted once weekly for 12 weeks (45 minutes each).

Behavioral: Perception-Action Approach

Neurodevelopmental Therapy (NDT-Bobath)

ACTIVE COMPARATOR

Participants receive physiotherapy based on Neurodevelopmental Therapy (Bobath), a holistic and individualized approach to neurorehabilitation. The intervention focuses on the analysis and facilitation of functional movement within meaningful activities to improve participation. Assessment and treatment are closely integrated, with therapy continuously adapted based on the child's responses. Active participation of the child is emphasized. Therapists may use hands-on facilitation, including key points of control, to support alignment, postural organization, and the regulation of muscle tone, aiming to improve the quality of movement during functional tasks. Activities are individualized and embedded in functional contexts, with assistance adapted to the child's needs. Sessions are conducted once weekly for 12 weeks (45 minutes each).

Behavioral: Neurodevelopmental Therapy (Bobath)

Interventions

Perception-Action Approach BEHAVIORAL

A physiotherapy intervention based on the Perception-Action Approach, emphasizing active exploration, self-initiated movement, and variability within meaningful tasks.

Perception-Action Approach (PA)

Neurodevelopmental Therapy (Bobath) BEHAVIORAL

A physiotherapy intervention based on Neurodevelopmental Therapy (Bobath), using therapeutic handling and facilitation to support alignment, postural organization, and movement quality during functional activities.

Neurodevelopmental Therapy (NDT-Bobath)

Eligibility Criteria

• Age: 6 Months - 36 Months
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Diagnosis of Cerebral Palsy
• Being at high risk for Cerebral Palsy (based on MRI or cranial ultrasound findings and neurological examination)
• Age between 0-36 months (using corrected age for preterm infants)
• Parental agreement to participate in the study and attend all assessment and therapy sessions; signed informed consent form from the parent(s) or legal guardian(s)

You may not qualify if:

• Presence of severe visual or hearing impairment that would prevent full participation in therapy sessions
• Uncontrolled seizures
• Receipt of botulinum toxin injection or orthopedic surgery within the last 6 months
• Diagnosis of an additional neurometabolic, genetic, or other neurological disorder

Sponsors & Collaborators

• Tuba Derya Doğan: lead

Related Publications (5)

• Pick, H. L. (1994). Eleanor J. Gibson: Learning to perceive and perceiving to learn. In A century of developmental psychology (pp. 527-544). American Psychological Association. https://doi.org/10.1037/10155-018

  BACKGROUND

• Harbourne RT, Willett S, Kyvelidou A, Deffeyes J, Stergiou N. A comparison of interventions for children with cerebral palsy to improve sitting postural control: a clinical trial. Phys Ther. 2010 Dec;90(12):1881-98. doi: 10.2522/ptj.2010132. Epub 2010 Oct 21.

  PMID: 20966212 BACKGROUND

• Hadders-Algra M, Boxum AG, Hielkema T, Hamer EG. Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review. Dev Med Child Neurol. 2017 Mar;59(3):246-258. doi: 10.1111/dmcn.13331. Epub 2016 Dec 7.

  PMID: 27925172 BACKGROUND

• Damiano DL, Longo E. Early intervention evidence for infants with or at risk for cerebral palsy: an overview of systematic reviews. Dev Med Child Neurol. 2021 Jul;63(7):771-784. doi: 10.1111/dmcn.14855. Epub 2021 Apr 6.

  PMID: 33825199 BACKGROUND

• Butler C, Darrah J. Effects of neurodevelopmental treatment (NDT) for cerebral palsy: an AACPDM evidence report. Dev Med Child Neurol. 2001 Nov;43(11):778-90. doi: 10.1017/s0012162201001414. No abstract available.

  PMID: 11730153 BACKGROUND

MeSH Terms

Conditions

Cerebral Palsy

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Dilek Çokar, PHd

  İstinye University

  STUDY DIRECTOR

Central Study Contacts

Tuba D Doğan, PT, MSc, PhD(c)

CONTACT

+905324090941; tubaderyadogan@gmail.com

Turgay Altunalan, PHd

CONTACT

+90 506 593 88 82; turgay.altunalan@ktu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: PhD Candidate

Model Details: Participants will be randomly assigned to one of two parallel intervention groups: the Perception-Action Approach group or the Neurodevelopmental Treatment (Bobath) group. Each participant will receive only one of the two interventions, delivered once weekly for 12 weeks, and outcomes will be assessed before and after the intervention period.

Study Record Dates

• First Submitted: May 4, 2026
• First Posted: May 8, 2026
• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): April 1, 2027
• Last Updated: May 8, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share