Effects of treadmill training on motor function balance and spasticity reduction in children with cerebral palsy: A randomized clinical trail

Background: Cerebral palsy (CP) is the leading cause of childhood motor disability, often associated with impaired, poor balance and spasticity, which limits daily activities and reduces quality of life. Treadmill training has emerged as a promising therapeutic intervention aimed at enhancing these impairments. Objective: To evaluate the effects of treadmill training on motor function, balance, and Spasticity in Spastic CP children Methods: The randomized control trial was conducted at Helping Hand Comprehensive Physical Rehab Centre, Lower Dir, from June 2024 to January 2025. A total of n=36 children with spastic CP aged 4-12 with GMFCS levels I and II were included in the study. The GMFCS, pediatric balance scale (PBS), and modified Ashworth scale (MAS) were used to assess motor function, balance, and spasticity. Out of n=36 CP children, n=18 individuals received treadmill training along with conventional therapy, and n=18 received conventional therapy only. The assessments were done at the beginning, after 4 weeks, 8 weeks, and 12 weeks of training. Results: The mean age of 8.17±2.21 years, having 42.6% male and 24.15% female. A non-significant interaction effect between intervention and time effect on spasticity {F(3,102)=0.81, p=0.489, ηp²=0.02} measured by modified Ashworth scale. While in PBS {F(3,102)=36.41, p=0.489, ηp²=0.517} significant interaction effect observed. Regarding motor functions, the Friedman test did not indicate overall significant (p≥0.05) change in GMFCS scores over time in both the experimental and control groups, and Wilcoxon signed-rank tests also confirmed insignificant (p≥0.05) changes between adjacent time points. Conclusion: Progressive treadmill protocol when combined with conventional therapy, can produce clinically meaningful improvements in balance and spasticity in children with CP, even though it may not alter gross motor function classification in the short term. Keywords: balance; cerebral palsy; motor function; spasticity; treadmill training. Clinical Trail #: NCT06463301