Structured Graphic Motor Therapy in Pediatric CP

Structured Graphic Motor Therapy (SGMT) is a novel task-oriented rehabilitation approach that uses standardized, progressively challenging drawing trajectories to improve upper-limb motor function in children with cerebral palsy. This pilot randomized controlled trial will compare SGMT combined with conventional rehabilitation with conventional upper-limb rehabilitation alone over a 16-week intervention period. Standardized clinical assessments and quantitative image-derived measures of graphical motor performance will be used to evaluate changes in motor function, visuomotor coordination, and movement quality.

Inclusion Criteria: * Children aged 8 to 12 years. Confirmed diagnosis of cerebral palsy with unilateral or predominantly unilateral upper-limb motor impairment. Sufficient voluntary movement of the affected upper limb to grasp and manipulate a drawing instrument on a supported horizontal surface. Adequate visual, auditory, cognitive, and communication abilities to understand study instructions and complete standardized rehabilitation tasks. Ability to follow standardized two-step verbal commands. Written informed consent provided by a parent or legal guardian and age-appropriate assent provided by the child. Exclusion Criteria: * Uncontrolled epilepsy. Fixed upper-limb contracture preventing completion of the intervention tasks. Orthopedic surgery involving the upper limb within the previous 6 months. Botulinum toxin injection affecting the upper limb within the previous 6 months. Severe uncorrected visual impairment. Clinically significant upper-limb pain that interferes with task performance. Unstable medical condition that could interfere with participation. Participation in another intensive upper-limb rehabilitation program during the study period.