Investigation of the effect of action observation treatment on balance and lower extremity function in chi̇ldren with hemiparetic cerebral palsy

The aim of this study was to investigate the contribution of action observation therapy (AOT) to Balance and lower extremity function in children with hemiparetic cerebralpalsy (hCP). The study included 20 children diagnosed with hCP, aged between 5 and 12 years (meanage: 9.60 ± 2.19 years), categorized as Level I and II according to the Gross Motor Function Classification System (GMFCS) (study group: 10, control group: 10). The children in the control group (n=10) received conventional physicaltherapy, while the children in the study group (n=10) received both conventional physical therapy and AOT intervention approaches. All children participating in the study were evaluated by a physical therapist before treatment and after 6 weeks of treatment. After recording the demographic and disease-related information of the children with hCP, Balance was assessed using the Timed Up and Go Test (TUGT) and the Pediatric Balance Scale (PBS); lower extremity performance was evaluated using the 5-Step Stair Climb Test (5SSCT) and the 6-Minute Walk Test (6MWT). When comparing the groups, significant differences were found in favor of the study group in terms of TUGT (p=0.002), 6MWT (p=0.005), 5SSCT (p=0.001), and PBS (p=0.005). Correlation analysis of the individuals with Hcp revealed that in the study group, there was a statistically significant, positive, and strong correlation between the change in the initial TUGT measurement and the change in the initial 5SSCT measurement (r=0.818). Additionally, a statistically significant, positive, and moderate correlation was found between the change in the average TUGT measurement and the change in 6MWT scores (r=0.636). Furthermore, there was a statistically significant, positive, and strong correlation between the change in the average TUGT measurement and the change in the initial 5SSCT scores (r=0.709). In the control group, a statistically significant, positive, and strong correlation was found only between the change in the average TUGT score and the change in the best 5SSCT score (r=0.733). As a result of our study, it was found that in children with hCP, AOT applied in addition to conventional physical therapy was more effective in improving Balance skills and lower extremity function compared to conventional physical therapy alone. We believe that adding AOT to conventional physicaltherapy in lower extremity and balance rehabilitation will positively contribute to the rehabilitation process.