Effect Of Task-Oriented Training Based On Neurodevelopment Therapy Principle On Gait And Functional Activities Of Daily Living In Cerebral Palsy-A Research Article

Abstract

Background:
Cerebral palsy (CP) is a leading cause of childhood physical disability, characterized by motor impairments that hinder gait and activities of daily living (ADLs). Neurodevelopmental Therapy (NDT) and Task-Oriented Training (TOT) are evidence-based approaches targeting functional recovery in children with CP. However, limited research exists on their combined effectiveness.

Objective:
To evaluate the effectiveness of task-oriented training based on Neurodevelopmental Therapy principles on gait parameters and functional activities of daily living in children with  cerebral palsy.

Methods:
A randomized controlled trial was conducted involving 102 children aged 5–12 years with CP (GMFCS levels I–III). Participants were randomly assigned to either an experimental group (n=51) receiving NDT-based task-oriented training or a control group (n=51) receiving conventional physiotherapy. Interventions were administered 3 times weekly for 6 Monthss. Primary outcome measures included gait speed (10MWT), step length, cadence, and gross motor function (GMFM-88). Secondary outcomes assessed functional performance through the Functional Mobility Scale (FMS), time for sit-to-stand and stand-to-sit, and adherence metrics.

Results:
The experimental group showed significantly greater improvements compared to the control group in gait speed (0.71 ± 0.10 m/s vs. 0.29 ± 0.05 m/s), stride length (0.60 ± 0.08 m vs. 0.20 ± 0.03 m), cadence (+12 steps/min), and GMFM-88 scores (+12.13 vs. +8.14). Functional task times (sit-to-stand and stand-to-sit) improved significantly in the experimental group. Adherence rates were also higher in the experimental group (overall adherence: 87.80% vs. 81.60%, p < 0.05).

Conclusion:
Task-oriented training based on Neurodevelopmental Therapy principles is significantly more effective than conventional physiotherapy in improving gait performance and daily functional independence in children with spasti CP. This combined approach enhances motor learning, engagement, and rehabilitation outcomes. It should be considered a viable strategy in paediatric neurorehabilitation programs targeting functional mobility and ADLs.