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

NCT07739069 | Not Yet Recruiting

• 1 other identifier: P.T.Rec/012/006210
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Hemiplegic Cerebral Palsy

Keywords

Hemiplegic Cerebral Palsy; Mirror Therapy; Action Observation Therapy

Outcome Measures

Primary Outcomes (1)

• gross manual dexterity

  Hand dexterity will be assessed using the Box and Block Test by recording the number of blocks transferred from one compartment to the other within 60 seconds.

  After 12 Weeks

Secondary Outcomes (2)

• Spontaneous Functional Analysis (SFA) of the Shriners Hospital Upper Extremity Evaluation (SHUEE)

  After 12 weeks

• Grip strength assessed using a hand dynamometer

  After 12 weeks

Study Arms (2)

Action Observation Therapy Group

EXPERIMENTAL

Participants will receive conventional physical therapy program for 45 minutes followed by 45 minutes of action observation therapy, three times per week for 12 weeks..

Behavioral: Action Observation Therapy

Mirror Therapy Group

ACTIVE COMPARATOR

Participants will receive the same conventional physical therapy program for 45 minutes followed by 45 minutes of mirror therapy, three times per week for 12 weeks.

Behavioral: Mirror Therapy

Interventions

Mirror Therapy BEHAVIORAL

Participants will receive 45-minute mirror therapy sessions in addition to the traditional physical therapy program, three sessions per week for 12 consecutive weeks. During mirror therapy, the child will be seated with a mirror positioned in the midsagittal plane to reflect movements of the unaffected upper limb while concealing the affected upper limb, creating the visual illusion of normal movement in the affected limb. Children will observe the reflected movements while simultaneously attempting to perform the same functional tasks with the affected upper limb. The intervention includes task-oriented upper extremity activities such as object transfer, grasp and release, coin placement, ball gripping, card turning, circle drawing, block building, and water pouring.

Mirror Therapy Group

Action Observation Therapy BEHAVIORAL

Participants will receive 45-minute action observation therapy sessions in addition to the traditional physical therapy program, three sessions per week for 12 consecutive weeks. During each session, children will observe videos demonstrating goal-directed upper extremity activities matched to their functional level, followed by performance of the same activities using the affected upper limb under therapist supervision. The intervention includes task-oriented activities such as block transfer, line drawing, card turning, coin placement, cup stacking, ball squeezing, water pouring and drinking, and moving beverage cans. Video demonstrations are presented from multiple viewing angles to facilitate motor learning and action observation.

Action Observation Therapy Group

Eligibility Criteria

• Age: 5 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• 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.

You may not qualify if:

• The children will be excluded if they have one of the following:
• Children with fixed contracture in the affected U.L.
• Injection of botulinum toxin into the upper limb muscles during the previous 6 months.
• Visual or Auditory disorders.
• Upper limb surgery in the last one year.
• Epilepsy.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

outpatient clinic of Faculty of Physical Therapy, Cairo University & outpatient clinic of Faculty of Physical Therapy, Misr University for Science and Technology, Egypt

Giza, 12512, Egypt

Location

MeSH Terms

Interventions

Mirror Movement Therapy

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics

Study Design

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

Model Details: Eligible participants will be randomly assigned in a 1:1 ratio to one of two intervention groups. The mirror therapy group will receive a conventional physical therapy program followed by 45 minutes of mirror therapy, while the action observation therapy group will receive the same conventional physical therapy program followed by 45 minutes of action observation therapy. Both groups will receive treatment three times per week for 12 weeks. Outcomes will be compared between the two groups to evaluate the effectiveness of the interventions in children with hemiplegic cerebral palsy.

Study Record Dates

• First Submitted: July 28, 2026
• First Posted: July 31, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): November 1, 2026
• Last Updated: July 31, 2026

Record last verified: 2026-07

Locations

EG (1)