Effect of the Forward, Backward and Side Ways Gait Training Intervention on Balance and Gait in Children with Spastic Diplegic Cerebral Palsy

Abstract

Background: Cerebral palsy (CP) is a group of permanent disorders caused by a non-progressive lesion in the developing brain where posture and movement disorders lead to activity limitations. Comparing the effects of forward, backward, and sideways gait training interventions on balance and gait metrics in children with spastic Diplegic cerebral palsy was the goal of the study. Classification System (GMFCS). The Modified Ashworth Scale (MAS) said that all of the people who took part had spasticity grades between 1 and 1+. Results: Post-intervention results showed significant improvements across all outcome measures. Initially, GMFM subscores (GMFM-D, GMFM-E), stride length, gait speed, and step breadth were similar across groups. After 12 weeks, the combination training group outperformed others, particularly the backward and sideways groups. All groups improved in GMFM scores, but the combination group showed superior gains in standing (GMFM-D), walking/running/jumping (GMFM-E), and overall function. Gait parameters also improved notably, with the combination group achieving longest strides, fastest speeds, and narrowest step widths. These findings suggest that multi-directional gait training is more effective than single-directional approaches for enhancing both static and dynamic motor skills in children with spastic diplegic CP. Conclusion: Multi-directional gait training, which includes walking forward, backward, and sideways, is better for balance, gross motor function, and gait performance in children with spastic diplegic CP than single-directional training methods. Methods: This prospective randomized study was carried out on 60 children, aged 5 to 7 years old, who had spastic diplegia and were rated as Level I or II on the Gross Motor Function