Spastic Cerebral Palsy (sCP)NCT07403162
Cuevas Medek Exercises to Improve Postural Control and Balance in Children With Spastic Cerebral Palsy
A study testing Cuevas medek exercises and Conventional Therapy in people with Spastic Cerebral Palsy (sCP), run by Riphah International University at 1 site in Pakistan.
Trial summary
This study aims to evaluate the effects of Cuevas Medek Exercises on postural control and balance in children with spastic cerebral palsy. Children meeting the eligibility criteria will be randomly allocated into two groups receiving Cuevas Medek Exercises or conventional therapy. Read more about this study
- Who is it for?
- Ages 2 to 6 years
- Conditions the study is for
- Spastic Cerebral Palsy (sCP)
- What is being tested?
- Cuevas medek exercises and Conventional Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 54 participants
- Where
- 1 sitePakistan
- Study dates
- 5 Jan 2026to 15 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 2 to 6 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Diagnosed with spastic diplegic cerebral palsy
- GMFCS Level III to V
- Modified Ashworth Scale ≤ 2
- Able to follow simple commands
Who cannot join
- Severe cognitive impairment
- Uncontrolled epilepsy or frequent seizures
- Visual or hearing impairment limiting treatment
- History of recent orthopedic or neurosurgical procedures
- Other neurological disorders (genetic syndromes, traumatic brain injury)
- Participation in other experimental therapies during the study period
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Cuevas Medek Exercises on Postural Control and Balance in Children With Spastic Cerebral Palsy
This study aims to evaluate the effects of Cuevas Medek Exercises on postural control and balance in children with spastic cerebral palsy. Children meeting the eligibility criteria will be randomly allocated into two groups receiving Cuevas Medek Exercises or conventional therapy. The outcomes will be assessed before and after the intervention period to determine the effectiveness of the intervention.
Read the detailed description
Spastic cerebral palsy is a common condition characterized by impaired postural control, poor balance, and limitations in functional movement, which affect a child's ability to maintain stability during daily activities. Conventional physiotherapy is commonly used to address these impairments through strengthening, stretching, and task-based exercises, with variable functional outcomes.
Cuevas Medek Exercises is a dynamic therapeutic approach that focuses on activating automatic postural responses and balance reactions through progressively challenging activities with minimal external support. While this approach has shown potential benefits in improving motor control and postural responses, evidence comparing its effects on postural control and balance with conventional therapy in children with spastic cerebral palsy remains limited.
Therefore, a randomized controlled trial is needed to compare the effects of Cuevas Medek Exercises and conventional therapy on postural control and balance in children with spastic cerebral palsy, with the aim of providing evidence to support clinical decision-making in pediatric physiotherapy
- Conditions
- Spastic Cerebral Palsy (sCP)
- Being tested
- Cuevas medek exercises, Conventional Therapy
- Keywords
- Cerebral palsy, Postural balance, Postural control, Pediatric physical therapy
- Medical subject headings
- Cerebral Palsy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cuevas medek exercisesOther
Also called CME
Children will receive Cuevas Medek Exercises 3 sessions per week, at an appropriate effort level guided by the therapist, each session lasting 30 minutes, focusing on dynamic postural activation, balance reactions, and functional movement tasks
Conventional TherapyOther
Children will receive conventional physiotherapy 3 sessions per week, at moderate effort suitable for age and condition, each session 30 minutes long, including stretching, strengthening, and task-oriented activities to improve postural control and balance
| Study group | Role | What they receive |
|---|---|---|
| cuevas medek exercise | Experimental | Children in this group will receive Cuevas Medek Exercises focusing on activation of postural responses and balance control through progressively challenging activities during the intervention period Receives: Other: Cuevas medek exercises |
| Conventional therapy | Active comparator | Children in this group will receive conventional physiotherapy including stretching, strengthening, and task-oriented activities aimed at improving postural control and balance Receives: Other: Conventional Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postural Control
Changes from baseline in postural control will be assessed using the Posture and Postural Ability Scale (PPAS). The scale evaluates the child's ability to maintain posture during functional tasks and measures automatic postural responses. The PPAS consists of several domains including trunk control, limb alignment, and dynamic balance. The scoring ranges from 0 to 30, where 0 indicates no disability and 30 indicates maximum postural impairment.
Measured: At the end of 4 weeks of intervention
Secondary outcomes (1)
Balance
Changes from baseline in balance will be assessed using the Pediatric Balance Scale (PBS). The PBS evaluates balance in sitting, standing, and during functional tasks such as reaching and turning. The scale consists of 14 items, each scored from 0 to 4, giving a total score ranging from 0 (poor balance) to 56 (excellent balance).
Measured: At the end of 4 weeks of intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2026
- Study start5 Jan 2026
- Primary completion1 Jun 2026
- Study completion15 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (12)Papers the sponsor has linked to this study.
- Other trials for Spastic Cerebral Palsy (sCP)Studies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 54 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ayesha Bashir, PhD, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07403162
- Sponsor's protocol ID
- 02330 Rimsha Waheed
- Status last verified
- Jul 2026
- First submitted
- 4 Feb 2026
- Last updated
- 20 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ferreira AD, Gerzson LR, de Almeida CS, Lopes GB. Cuevas Medek exercises a neurological rehabilitation for children, the effect in developmental hip dysplasia in a patient with cerebral palsy: case study. Arquivos de Neuro-Psiquiatria. 2023;81(S 01):A056.
Mitroi S. Stimulation of triple extension tone and orthostatic balance in the child with cerebral palsy through exercises specific to Medek method. Physical Education, Sport and Kinesiology Journal. 2016;1(43):48-51
Milne N, Neustaeter A, Thomas H, Ritter M, Macdonald K. Review Protocol: EXPLORING THE EFFECTIVENESS OF CUEVAS MEDEK EXERCISES (CME) IN PAEDIATRIC POPULATIONS: A SYSTEMATIC SCOPING REVIEW. 2023
Yun G, Huang M, Cao J, Hu X. Selective motor control correlates with gross motor ability, functional balance and gait performance in ambulant children with bilateral spastic cerebral palsy. Gait Posture. 2023 Jan;99:9-13. doi: 10.1016/j.gaitpost.2022.10.009. Epub 2022 Oct 19.
PubMed 36283302Adiguzel H, Elbasan B. Effects of modified pilates on trunk, postural control, gait and balance in children with cerebral palsy: a single-blinded randomized controlled study. Acta Neurol Belg. 2022 Aug;122(4):903-914. doi: 10.1007/s13760-021-01845-5. Epub 2022 Jan 18.
PubMed 35040072Elnaggar RK, Ramirez-Campillo R, Azab AR, Alrawaili SM, Alghadier M, Alotaibi MA, Alhowimel AS, Abdrabo MS, Elbanna MF, Aboeleneen AM, Morsy WE. Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics. Children (Basel). 2024 Feb 15;11(2):243. doi: 10.3390/children11020243.
PubMed 38397355Crenshaw JR, Petersen DA, Conner BC, Tracy JB, Pigman J, Wright HG, Miller F, Johnson CL, Modlesky CM. Anteroposterior balance reactions in children with spastic cerebral palsy. Dev Med Child Neurol. 2020 Jun;62(6):700-708. doi: 10.1111/dmcn.14500. Epub 2020 Mar 2.
PubMed 32124436Bickley C, Linton J, Sullivan E, Mitchell K, Slota G, Barnes D. Comparison of simultaneous static standing balance data on a pressure mat and force plate in typical children and in children with cerebral palsy. Gait Posture. 2019 Jan;67:91-98. doi: 10.1016/j.gaitpost.2018.08.012. Epub 2018 Aug 16.
PubMed 30308334Woollacott MH, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance? Neural Plast. 2005;12(2-3):211-9; discussion 263-72. doi: 10.1155/NP.2005.211.
PubMed 16097489Paul S, Nahar A, Bhagawati M, Kunwar AJ. A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022 Jul 30;2022:2622310. doi: 10.1155/2022/2622310. eCollection 2022.
PubMed 35941906Gulati S, Sondhi V. Cerebral Palsy: An Overview. Indian J Pediatr. 2018 Nov;85(11):1006-1016. doi: 10.1007/s12098-017-2475-1. Epub 2017 Nov 20.
PubMed 29152685Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, Stumbles E, Wilson SA, Goldsmith S. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013 Oct;55(10):885-910. doi: 10.1111/dmcn.12246. Epub 2013 Aug 21.
PubMed 23962350
Study at a glance
From the registry record, last updated by the sponsor on 20 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Cuevas Medek Exercises on Postural Control and Balance in Children With Spastic Cerebral Palsy
- ClinicalTrials.gov ID
- NCT07403162
- Acronym / sponsor ID
- 02330 Rimsha Waheed
- Conditions
- Spastic Cerebral Palsy (sCP)
- Keywords
- Cerebral palsy, Postural balance, Postural control, Pediatric physical therapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 54 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 5 Jan 2026 (actual)
- Primary completion
- 1 Jun 2026 (actual)
- Study completion
- 15 Jun 2026 (actual)
- First posted
- 11 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to evaluate the effects of Cuevas Medek Exercises on postural control and balance in children with spastic cerebral palsy. Children meeting the eligibility criteria will be randomly allocated into two groups receiving Cuevas Medek Exercises or conventional therapy. The outcomes will be assessed before and after the intervention period to determine the effectiveness of the intervention.
Detailed description
Spastic cerebral palsy is a common condition characterized by impaired postural control, poor balance, and limitations in functional movement, which affect a child's ability to maintain stability during daily activities. Conventional physiotherapy is commonly used to address these impairments through strengthening, stretching, and task-based exercises, with variable functional outcomes.
Cuevas Medek Exercises is a dynamic therapeutic approach that focuses on activating automatic postural responses and balance reactions through progressively challenging activities with minimal external support. While this approach has shown potential benefits in improving motor control and postural responses, evidence comparing its effects on postural control and balance with conventional therapy in children with spastic cerebral palsy remains limited.
Therefore, a randomized controlled trial is needed to compare the effects of Cuevas Medek Exercises and conventional therapy on postural control and balance in children with spastic cerebral palsy, with the aim of providing evidence to support clinical decision-making in pediatric physiotherapy
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| cuevas medek exercise | Experimental | Other: Cuevas medek exercisesChildren in this group will receive Cuevas Medek Exercises focusing on activation of postural responses and balance control through progressively challenging activities during the intervention period |
| Conventional therapy | Active comparator | Other: Conventional TherapyChildren in this group will receive conventional physiotherapy including stretching, strengthening, and task-oriented activities aimed at improving postural control and balance |
Who may qualify
- Ages
- 2 to 6 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Diagnosed with spastic diplegic cerebral palsy
- GMFCS Level III to V
- Modified Ashworth Scale ≤ 2
- Able to follow simple commands
Key exclusion criteria (6 listed)
- Severe cognitive impairment
- Uncontrolled epilepsy or frequent seizures
- Visual or hearing impairment limiting treatment
- History of recent orthopedic or neurosurgical procedures
- Other neurological disorders (genetic syndromes, traumatic brain injury)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cuevas medek exercisesAlso: CMEChildren will receive Cuevas Medek Exercises 3 sessions per week, at an appropriate effort level guided by the therapist, each session lasting 30 minutes, focusing on dynamic postural activation, balance reactions, and functional movement tasks | Other | cuevas medek exercise |
| Conventional TherapyChildren will receive conventional physiotherapy 3 sessions per week, at moderate effort suitable for age and condition, each session 30 minutes long, including stretching, strengthening, and task-oriented activities to improve postural control and balance | Other | Conventional therapy |
Primary outcome
Postural Control
Time frame: At the end of 4 weeks of intervention
Changes from baseline in postural control will be assessed using the Posture and Postural Ability Scale (PPAS). The scale evaluates the child's ability to maintain posture during functional tasks and measures automatic postural responses. The PPAS consists of several domains including trunk control, limb alignment, and dynamic balance. The scoring ranges from 0 to 30, where 0 indicates no disability and 30 indicates maximum postural impairment.
1 secondary outcome
Balance
Time frame: At the end of 4 weeks of intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jul 2026.
- BackgroundFerreira AD, Gerzson LR, de Almeida CS, Lopes GB. Cuevas Medek exercises a neurological rehabilitation for children, the effect in developmental hip dysplasia in a patient with cerebral palsy: case study. Arquivos de Neuro-Psiquiatria. 2023;81(S 01):A056.
- BackgroundMitroi S. Stimulation of triple extension tone and orthostatic balance in the child with cerebral palsy through exercises specific to Medek method. Physical Education, Sport and Kinesiology Journal. 2016;1(43):48-51
- BackgroundMilne N, Neustaeter A, Thomas H, Ritter M, Macdonald K. Review Protocol: EXPLORING THE EFFECTIVENESS OF CUEVAS MEDEK EXERCISES (CME) IN PAEDIATRIC POPULATIONS: A SYSTEMATIC SCOPING REVIEW. 2023
- Background: PubMed 36283302Yun G, Huang M, Cao J, Hu X. Selective motor control correlates with gross motor ability, functional balance and gait performance in ambulant children with bilateral spastic cerebral palsy. Gait Posture. 2023 Jan;99:9-13. doi: 10.1016/j.gaitpost.2022.10.009. Epub 2022 Oct 19.
- Background: PubMed 35040072Adiguzel H, Elbasan B. Effects of modified pilates on trunk, postural control, gait and balance in children with cerebral palsy: a single-blinded randomized controlled study. Acta Neurol Belg. 2022 Aug;122(4):903-914. doi: 10.1007/s13760-021-01845-5. Epub 2022 Jan 18.
- Background: PubMed 38397355Elnaggar RK, Ramirez-Campillo R, Azab AR, Alrawaili SM, Alghadier M, Alotaibi MA, Alhowimel AS, Abdrabo MS, Elbanna MF, Aboeleneen AM, Morsy WE. Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics. Children (Basel). 2024 Feb 15;11(2):243. doi: 10.3390/children11020243.
- Background: PubMed 32124436Crenshaw JR, Petersen DA, Conner BC, Tracy JB, Pigman J, Wright HG, Miller F, Johnson CL, Modlesky CM. Anteroposterior balance reactions in children with spastic cerebral palsy. Dev Med Child Neurol. 2020 Jun;62(6):700-708. doi: 10.1111/dmcn.14500. Epub 2020 Mar 2.
- Background: PubMed 30308334Bickley C, Linton J, Sullivan E, Mitchell K, Slota G, Barnes D. Comparison of simultaneous static standing balance data on a pressure mat and force plate in typical children and in children with cerebral palsy. Gait Posture. 2019 Jan;67:91-98. doi: 10.1016/j.gaitpost.2018.08.012. Epub 2018 Aug 16.
- Background: PubMed 16097489Woollacott MH, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance? Neural Plast. 2005;12(2-3):211-9; discussion 263-72. doi: 10.1155/NP.2005.211.
- Background: PubMed 35941906Paul S, Nahar A, Bhagawati M, Kunwar AJ. A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022 Jul 30;2022:2622310. doi: 10.1155/2022/2622310. eCollection 2022.
- Background: PubMed 29152685Gulati S, Sondhi V. Cerebral Palsy: An Overview. Indian J Pediatr. 2018 Nov;85(11):1006-1016. doi: 10.1007/s12098-017-2475-1. Epub 2017 Nov 20.
- Background: PubMed 23962350Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, Stumbles E, Wilson SA, Goldsmith S. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013 Oct;55(10):885-910. doi: 10.1111/dmcn.12246. Epub 2013 Aug 21.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ayesha Bashir, PhD principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Cuevas medek exercises and Conventional Therapy in people with Spastic Cerebral Palsy (sCP), run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postural Control (time frame: At the end of 4 weeks of intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07403162, which also lists 12 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jul 2026.