Effect of Treadmill Gait Training Combined With Conventional Physiotherapy on Gait Performance and Functional Mobility in Children With Bilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

Cerebral palsy is a neurological condition that affects movement, muscle control, and walking ability in children. Children with bilateral spastic cerebral palsy often experience increased muscle stiffness, difficulty with walking, reduced balance, and limited functional mobility. This randomized controlled trial aims to evaluate whether treadmill gait training combined with conventional physiotherapy can improve walking ability, gross motor function, balance, and mobility compared with conventional physiotherapy alone. Children with bilateral spastic cerebral palsy will receive a 12-week rehabilitation program, and changes in motor function, gait performance, spasticity, and walking endurance will be assessed before and after treatment.

Inclusion Criteria * Clinically confirmed diagnosis of bilateral spastic cerebral palsy. * Aged 6 to 16 years. * Classified as GMFCS Levels I-III. * Able to stand independently, with or without support. * Presence of clinically significant lower-limb spasticity, defined as Modified Ashworth Scale (MAS) score ≥2. * Demonstrated ambulatory ability with Timed Up and Go (TUG) ≤10 seconds. * Demonstrated walking ability with 6-Minute Walk Test (6MWT) distance of 50-500 meters at baseline. * Able to understand simple verbal commands and participate in structured therapy sessions. * Parent or legal guardian willing to provide written informed consent. * Willing and able to attend the complete 12-week intervention protocol. Exclusion Criteria * Botulinum toxin injection within the previous 6 months. * Recent pharmacological intervention significantly affecting spasticity. * Lower-limb orthopedic surgery within the previous 12 months. * Severe intellectual disability (IQ \