Cerebral Palsy (CP)NCT07612371
Effects of Motor Imagery and Action Observation on Motor Function in Unilateral Cerebral Palsy
A study testing motor imagery, Action observation therapy and Conventional physiotherapy group in people with Cerebral Palsy (CP), run by Bahçeşehir University at 1 site in Turkey (Türkiye).
Trial summary
The aim of this study is to evaluate the effects of action observation therapy and motor imagery methods, provided in addition to a conventional physiotherapy and rehabilitation program, on gross motor function, upper and lower extremity functional skills, and quality of life in children with cerebral palsy. Read more about this study
- Who is it for?
- Ages 7 to 16 years
- Conditions the study is for
- Cerebral Palsy (CP)
- What is being tested?
- motor imagery, Action observation therapy and Conventional physiotherapy group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 48 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 May 2026to Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 7 to 16 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Being between 7 and 16 years of age
- Having a diagnosis of unilateral cerebral palsy made by a pediatric neurologist
- Being classified at levels I-II of the Gross Motor Function Classification System (GMFCS)
- Scoring above 24 on the Mini-Mental State Examination for Children
- Having no cognitive impairments (i.e., possessing an appropriate cognitive level to follow task instructions)
- Willingness to participate in the study (child and family)
- Being classified at levels I-III of the Manual Ability Classification System (MACS) -Being classified at levels I-III of the Communication Function Classification System (CFCS) -
Who cannot join
- Children with uncontrolled seizures
- Children who have received motor imagery training or action observation therapy within the last 6 months
- Children with contractures
- Children with severe visual and/or hearing impairments
- Being classified at levels III, IV, or V according to the GMFCS
- Scoring below 24 on the Mini-Mental State Examination for Children
- Being classified at levels IV-V of the Manual Ability Classification System (MACS)
- Having undergone orthopedic surgery or botulinum toxin (Botox) treatment within the last 6 months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Kurtkoy Ozel Egitim ve Rehabilitasyon Merkezi
Istanbul
Burak Yaşar, +905050181505, bynsunal@gmail.com
Betul Unal, PhD (C)
About this study
Official title: Investigation of the Effects of Motor Imagery and Action Observation Therapy on Gross Motor Function, Upper Extremity Functional Skills, Activity, and Participation in Children With Unilateral Cerebral Palsy
The aim of this study is to evaluate the effects of action observation therapy and motor imagery methods, provided in addition to a conventional physiotherapy and rehabilitation program, on gross motor function, upper and lower extremity functional skills, and quality of life in children with cerebral palsy.
Read the detailed description
In children with unilateral cerebral palsy (CP), the ability to perform various hand activities is reduced. Sensory and motor impairments observed in the affected upper extremity are the main causes of functional limitations. These impairments restrict the ability to perform simple activities of daily living such as dressing, tooth brushing, hair combing, feeding, and playing, and also lead to limitations in activity and participation within a broader social context. Therefore, one of the primary goals of neurological rehabilitation in this population is to promote the effective use of the affected upper extremity in daily tasks by improving its capacity and performance, and to support the child's independence in daily living activities by enhancing skills and increasing participation in activities. However, approximately 75% of children with unilateral CP continue to demonstrate motor impairments in activities of daily living even when they participate in a comprehensive rehabilitation program including conventional physical therapy, orthotic use, and spasticity management. There is a need for new rehabilitation programs aimed at enhancing the effects of traditional treatments, which mainly involve motor interventions.
In CP rehabilitation, it is recommended to integrate motor training with environmental enrichment and to increase environmental stimuli in order to enhance task performance. These approaches are based on the implementation of real-life activity-based tasks through active movements, with high intensity and individualized goals. In this way, neuroplasticity is supported through attention, motivation, and intensive repetition. Furthermore, it is recommended that activity- and task-oriented motor training be complemented with cognitive interventions such as action observation therapy, motor imagery, and mirror therapy, which combine motor and cognitive rehabilitation approaches.
Motor imagery is the mental simulation of movement without any overt motor action and refers to the capacity to generate kinesthetic representations of motor actions. Motor imagery selectively stimulates the cognitive aspect of motor behavior and is considered a prerequisite for motor planning processes. Recent studies have shown that despite motor deficits related to movement execution in children with CP, the ability to imagine movements may remain preserved. Therefore, interventions focusing on motor planning and imagery have emerged as potential treatment options for CP. However, the number of studies investigating the effectiveness of motor imagery in the CP population is quite limited, and well-designed studies examining the effectiveness of motor imagery training in individuals with CP are needed.
Action Observation Therapy (AOT) is known to be a cognitive intervention used to improve various motor skills in patients with motor impairments. From a rehabilitation perspective, the mirror neuron system plays a major role in the human capacity to learn through imitation. Based on the mirror neuron system, action observation consists of systematically and repeatedly observing actions followed by the reproduction of the observed actions. Findings from studies using AOT have indicated that AOT improves activities of daily living and has been proposed as a novel neurophysiological approach focused on motor learning in CP rehabilitation. Nevertheless, well-designed studies investigating the effectiveness of action observation training in individuals with CP are still needed.
The aim of this study is to evaluate the effects of Action Observation Therapy and motor imagery methods, provided in addition to conventional rehabilitation, on gross motor function, upper and lower extremity functional skills, and quality of life in children with CP.
- Conditions
- Cerebral Palsy (CP)
- Being tested
- motor imagery, Action observation therapy, Conventional physiotherapy group
- Keywords
- motor imagery, Mirror Neurons, quality of life, Cognitive Training
- Medical subject headings
- Cerebral Palsy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
motor imageryOther
Participants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes.
The motor imagery practice will consist of a total of 10 movements including unimanual and bimanual, walking and balance activities, and will be performed by participants from both first-person and third-person perspectives.
Balance activities:
- Single-leg standing balance
- Sit and stand up with your arms crossed in front of you while sitting in the chair.
Walking activities:
- The child gets up from the chair without support, walks 3 meters, then returns and sits back down in the chair
- Walking sideways and backward on different surfaces
Bimauel upper extremity activities
- Putting on a blouse
- Putting on and zipping up/down a dress with a front zipper.
- Putting on shoes and tying the laces. Unimanual upper extremity activities
- Taking food from the plate with a spoon and putting it in the mouth
- Combing hair
- Holding the doorknob and opening
Action observation therapyOther
Participants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes.
Action observation therapy will consist of a total of 10 movements including unimanual and bimanual, walking and balance activities. After participants observe the movement (observation phase), they are asked to imitate the movement they observed (execution phase).
Balance activities:
- Single-leg standing balance
- Sit and stand up with your arms crossed in front of you while sitting in the chair.
Walking activities:
- The child gets up from the chair without support, walks 3 meters, then returns and sits back down in the chair
- Walking sideways and backward on different surfaces
Bimauel upper extremity activities
- Putting on a blouse
- Putting on and zipping up/down a dress with a front zipper.
- Putting on shoes and tying the laces. Unimanual upper extremity activities
- Taking food from the plate with a spoon and putting it in the mouth
Conventional physiotherapy groupOther
Participants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes. Conventional physiotherapy training will be structured according to the child's symptoms and needs, and will consist of stretching, strengthening, normal walking training, postural control training, and weight-bearing training in different positions (sitting, standing, side-lying, prone).
| Study group | Role | What they receive |
|---|---|---|
| Motor Imagery Group | Active comparator | Mental imagery practice will be applied in addition to conventional physiotherapy. A total of 10 movements supporting activities of daily living, including unimanual and bimanual upper extremity activities, walking, and balance activities, will be practiced from both first-person and third-person perspectives.
The intervention will be administered for 50 minutes per session, twice a week, for 8 weeks. The intervention protocol will consist of 20 minutes of conventional physiotherapy followed by 30 minutes of motor imagery practice. Receives: Other: motor imagery |
| Action Observation Therapy Group: | Active comparator | Action observation therapy will be applied in adition to conventional physiotherapy. A total of 10 movements supporting activities of daily living, including unimanual and bimanual upper extremity activities, walking, and balance activities, will be practiced. In action observation therapy, after participants observe the movement (observation phase), they will be asked to imitate the observed movement (execution phase). The intervention will be administered for 50 minutes per session, twice a week, for 8 weeks. The intervention protocol will consist of 20 minutes of conventional physiotherapy followed by 30 minutes of action observation therapy. Receives: Other: Action observation therapy |
| Conventional physiotherapy group | Active comparator | Conventional physiotherapy training will be structured according to the child's symptoms and needs, and will consist of stretching, strengthening, normal walking training, postural control training, and weight-bearing training in different positions (sitting, standing, side-lying, prone). Receives: Other: Conventional physiotherapy group |
What is being measured
The primary outcome is the main question the study is designed to answer.
ABILHAND-Kids
Manual ability in daily activities assessed using the ABILHAND-Kids questionnaire for children with cerebral palsy (measured as logit score using Rasch analysis). ABILHAND-Kids evaluates the child's perceived difficulty in performing daily bimanual activities, such as dressing (buttons, zippers), eating with utensils, using scissors or pencils, opening containers, handling small objects. Contains a list of everyday manual tasks Each item is rated based on difficulty: Impossible, difficult, easy. Higher scores indicate better manual ability.
Time Frame: 8 weeks
Measured: 0th week; 8th week
Secondary outcomes (6)
Pediatric Quality of Life Inventory (PedsQL)
Quality of life assessed using the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cerebral Palsy Module Child and Parent Reports. The 35-item questionnaire evaluates daily activities, school activities, movement and balance, pain, fatigue, eating activities, and speech and communication in children with cerebral palsy. Items are scored on a 5-point Likert scale and transformed to a 0-100 scale. Higher scores indicate better quality of life.
Measured: 0th week; 8th week
Jebsen-Taylor Hand Function Test
Hand function assessed using the Jebsen-Taylor Hand Function Test (JTHFT), a standardized measure of fine and gross motor hand function during simulated activities of daily living. The test consists of seven subtests, including writing, page turning, lifting small objects, simulated feeding, stacking, and lifting light and heavy objects. Performance is measured as completion time in seconds for each subtest and total test time using a stopwatch. Measurement method: Each task is performed as quickly as possible. Time is measured in seconds with a stopwatch. Each task is recorded separately. Scoring system: Time elapsed for each subtest (in seconds) is used. Total score: sum of subtest times or total time separately for each hand.
Lower completion time indicates better hand function.
Measured: 0th week; 8th week
The Child and Adolescent Scale of Participation (CASP)
The CASP questionnaire assesses an individual's community participation in home, school, and neighborhood settings. It consists of 20 questions in total, with 4 sub-sections: Home participation (6 questions), neighborhood and community participation (4 questions), school Participation (5 questions), and home and community activities (5 questions). Scoring system: 4 = expected for their age (full participation), 3= somewhat limited, very limited, 2=unable, and 1=not applicable. Total and/or domain scores are calculated, and scores transformed to a standardized 0-100 scale. Higher scores indicate better levels of participation in daily life activities.
Measured: 0th week; 8th week
Gross Motor Function Measure (GMFM)
Gross motor function assessed using the Gross Motor Function Measure (GMFM-88), a standardized assessment tool for children with cerebral palsy. The scale consists of 88 items across five domains: lying and rolling, sitting, crawling and kneeling, standing, and walking/running/jumping. Items are scored on a 4-point Likert scale according to the child's level of performance. Total scores range from 0 to 264, with higher scores indicating better gross motor function.
Measured: 0th week; 8th week
Timed Up and Go Test
Functional mobility assessed using the Timed Up and Go Test (TUG). Participants are instructed to stand up from a chair, walk 3 meters, turn around, return to the chair, and sit down. Completion time is measured in seconds using a stopwatch. Lower completion times indicate better functional mobility.
Measured: 0th week; 8th week
Five Times Sit-to-Stand Test
Lower extremity functional strength assessed using the Five Times Sit-to-Stand Test (5xSTS). Participants are instructed to stand up and sit down five times as quickly as possible from a standard chair without using upper extremity support. Completion time is measured in seconds using a stopwatch. Lower completion times indicate better functional performance.
Measured: 0th week; 8th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 May 2026
- Study start15 May 2026
- Primary completionOct 2026 (estimated)
- Study completionOct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Cerebral Palsy (CP)Studies of the same condition, open and under way.
- 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
- Model description
- Three groups with a conventional therapy control group
- Masking
- None (open label)
- Enrolment
- 48 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bahçeşehir University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Betul Unal, Bahçeşehir University
- Investigators
- Hasan K. Alptekin, Prof. Dr., Study chair, Bahçeşehir UniversityPelin Pisirici, Assoc. Prof., Study director, Bahçeşehir University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07612371
- Sponsor's protocol ID
- E-78097791-020-5100
- Status last verified
- May 2026
- First submitted
- 15 May 2026
- Last updated
- 28 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: IPD will be made available upon reasonable request after publication of the study results. Requests will be evaluated and approved by the principal investigator to ensure that the proposed use is methodologically sound and in accordance with ethical and institutional regulations. Data will be shared for academic and non-commercial research purposes only.
Publications
Steenbergen B, Jongbloed-Pereboom M, Spruijt S, Gordon AM. Impaired motor planning and motor imagery in children with unilateral spastic cerebral palsy: challenges for the future of pediatric rehabilitation. Dev Med Child Neurol. 2013 Nov;55 Suppl 4:43-6. doi: 10.1111/dmcn.12306.
PubMed 24237279Sgandurra G, Ferrari A, Cossu G, Guzzetta A, Fogassi L, Cioni G. Randomized trial of observation and execution of upper extremity actions versus action alone in children with unilateral cerebral palsy. Neurorehabil Neural Repair. 2013 Nov-Dec;27(9):808-15. doi: 10.1177/1545968313497101. Epub 2013 Jul 25.
PubMed 23886886Alamer A, Melese H, Adugna B. Effectiveness of Action Observation Training on Upper Limb Motor Function in Children with Hemiplegic Cerebral Palsy: A Systematic Review of Randomized Controlled Trials. Pediatric Health Med Ther. 2020 Sep 15;11:335-346. doi: 10.2147/PHMT.S266720. eCollection 2020.
PubMed 32982541Demeco A, Molinaro A, Ambroggi M, Frizziero A, Fazzi E, Costantino C, Buccino G. Cognitive approaches in the rehabilitation of upper limbs function in children with cerebral palsy: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2024 Jun;60(3):445-457. doi: 10.23736/S1973-9087.24.08288-1. Epub 2024 Mar 21.
PubMed 38512713Shin YK, Lee DR, Hwang HJ, You SJ, Im CH. A novel EEG-based brain mapping to determine cortical activation patterns in normal children and children with cerebral palsy during motor imagery tasks. NeuroRehabilitation. 2012;31(4):349-55. doi: 10.3233/NRE-2012-00803.
PubMed 23232157Buccino G, Molinaro A, Ambrosi C, Arisi D, Mascaro L, Pinardi C, Rossi A, Gasparotti R, Fazzi E, Galli J. Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study. Neural Plast. 2018 Jul 4;2018:4843985. doi: 10.1155/2018/4843985. eCollection 2018.
PubMed 30123250
Study at a glance
From the registry record, last updated by the sponsor on 28 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigation of the Effects of Motor Imagery and Action Observation Therapy on Gross Motor Function, Upper Extremity Functional Skills, Activity, and Participation in Children With Unilateral Cerebral Palsy
- ClinicalTrials.gov ID
- NCT07612371
- Acronym / sponsor ID
- E-78097791-020-5100
- Conditions
- Cerebral Palsy (CP)
- Keywords
- motor imagery, Mirror Neurons, quality of life, Cognitive Training
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 48 participants (estimated)
- Lead sponsor
- Bahçeşehir UniversityUniversity, hospital or other
- Study start
- 15 May 2026 (actual)
- Primary completion
- Oct 2026 (estimated)
- Study completion
- Oct 2026 (estimated)
- First posted
- 28 May 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.
The aim of this study is to evaluate the effects of action observation therapy and motor imagery methods, provided in addition to a conventional physiotherapy and rehabilitation program, on gross motor function, upper and lower extremity functional skills, and quality of life in children with cerebral palsy.
Detailed description
In children with unilateral cerebral palsy (CP), the ability to perform various hand activities is reduced. Sensory and motor impairments observed in the affected upper extremity are the main causes of functional limitations. These impairments restrict the ability to perform simple activities of daily living such as dressing, tooth brushing, hair combing, feeding, and playing, and also lead to limitations in activity and participation within a broader social context. Therefore, one of the primary goals of neurological rehabilitation in this population is to promote the effective use of the affected upper extremity in daily tasks by improving its capacity and performance, and to support the child's independence in daily living activities by enhancing skills and increasing participation in activities. However, approximately 75% of children with unilateral CP continue to demonstrate motor impairments in activities of daily living even when they participate in a comprehensive rehabilitation program including conventional physical therapy, orthotic use, and spasticity management. There is a need for new rehabilitation programs aimed at enhancing the effects of traditional treatments, which mainly involve motor interventions.
In CP rehabilitation, it is recommended to integrate motor training with environmental enrichment and to increase environmental stimuli in order to enhance task performance. These approaches are based on the implementation of real-life activity-based tasks through active movements, with high intensity and individualized goals. In this way, neuroplasticity is supported through attention, motivation, and intensive repetition. Furthermore, it is recommended that activity- and task-oriented motor training be complemented with cognitive interventions such as action observation therapy, motor imagery, and mirror therapy, which combine motor and cognitive rehabilitation approaches.
Motor imagery is the mental simulation of movement without any overt motor action and refers to the capacity to generate kinesthetic representations of motor actions. Motor imagery selectively stimulates the cognitive aspect of motor behavior and is considered a prerequisite for motor planning processes. Recent studies have shown that despite motor deficits related to movement execution in children with CP, the ability to imagine movements may remain preserved. Therefore, interventions focusing on motor planning and imagery have emerged as potential treatment options for CP. However, the number of studies investigating the effectiveness of motor imagery in the CP population is quite limited, and well-designed studies examining the effectiveness of motor imagery training in individuals with CP are needed.
Action Observation Therapy (AOT) is known to be a cognitive intervention used to improve various motor skills in patients with motor impairments. From a rehabilitation perspective, the mirror neuron system plays a major role in the human capacity to learn through imitation. Based on the mirror neuron system, action observation consists of systematically and repeatedly observing actions followed by the reproduction of the observed actions. Findings from studies using AOT have indicated that AOT improves activities of daily living and has been proposed as a novel neurophysiological approach focused on motor learning in CP rehabilitation. Nevertheless, well-designed studies investigating the effectiveness of action observation training in individuals with CP are still needed.
The aim of this study is to evaluate the effects of Action Observation Therapy and motor imagery methods, provided in addition to conventional rehabilitation, on gross motor function, upper and lower extremity functional skills, and quality of life in children with CP.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Three groups with a conventional therapy control group
| Arm | Type | Receives |
|---|---|---|
| Motor Imagery Group | Active comparator | Other: motor imageryMental imagery practice will be applied in addition to conventional physiotherapy. A total of 10 movements supporting activities of daily living, including unimanual and bimanual upper extremity activities, walking, and balance activities, will be practiced from both first-person and third-person perspectives. The intervention will be administered for 50 minutes per session, twice a week, for 8 weeks. The intervention protocol will consist of 20 minutes of conventional physiotherapy followed by 30 minutes of motor imagery practice. |
| Action Observation Therapy Group: | Active comparator | Other: Action observation therapyAction observation therapy will be applied in adition to conventional physiotherapy. A total of 10 movements supporting activities of daily living, including unimanual and bimanual upper extremity activities, walking, and balance activities, will be practiced. In action observation therapy, after participants observe the movement (observation phase), they will be asked to imitate the observed movement (execution phase). The intervention will be administered for 50 minutes per session, twice a week, for 8 weeks. The intervention protocol will consist of 20 minutes of conventional physiotherapy followed by 30 minutes of action observation therapy. |
| Conventional physiotherapy group | Active comparator | Other: Conventional physiotherapy groupConventional physiotherapy training will be structured according to the child's symptoms and needs, and will consist of stretching, strengthening, normal walking training, postural control training, and weight-bearing training in different positions (sitting, standing, side-lying, prone). |
Who may qualify
- Ages
- 7 to 16 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (7 listed)
- Being between 7 and 16 years of age
- Having a diagnosis of unilateral cerebral palsy made by a pediatric neurologist
- Being classified at levels I-II of the Gross Motor Function Classification System (GMFCS)
- Scoring above 24 on the Mini-Mental State Examination for Children
- Having no cognitive impairments (i.e., possessing an appropriate cognitive level to follow task instructions)
Key exclusion criteria (8 listed)
- Children with uncontrolled seizures
- Children who have received motor imagery training or action observation therapy within the last 6 months
- Children with contractures
- Children with severe visual and/or hearing impairments
- Being classified at levels III, IV, or V according to the GMFCS
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 |
|---|---|---|
| motor imageryParticipants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes. The motor imagery practice will consist of a total of 10 movements including unimanual and bimanual, walking and balance activities, and will be performed by participants from both first-person and third-person perspectives. Balance activities: * Single-leg standing balance * Sit and stand up with your arms crossed in front of you while sitting in the chair. Walking activities: * The child gets up from the chair without support, walks 3 meters, then returns and sits back down in the chair * Walking sideways and backward on different surfaces Bimauel upper extremity activities * Putting on a blouse * Putting on and zipping up/down a dress with a front zipper. * Putting on shoes and tying the laces. Unimanual upper extremity activities * Taking food from the plate with a spoon and putting it in the mouth * Combing hair * Holding the doorknob and opening | Other | Motor Imagery Group |
| Action observation therapyParticipants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes. Action observation therapy will consist of a total of 10 movements including unimanual and bimanual, walking and balance activities. After participants observe the movement (observation phase), they are asked to imitate the movement they observed (execution phase). Balance activities: * Single-leg standing balance * Sit and stand up with your arms crossed in front of you while sitting in the chair. Walking activities: * The child gets up from the chair without support, walks 3 meters, then returns and sits back down in the chair * Walking sideways and backward on different surfaces Bimauel upper extremity activities * Putting on a blouse * Putting on and zipping up/down a dress with a front zipper. * Putting on shoes and tying the laces. Unimanual upper extremity activities * Taking food from the plate with a spoon and putting it in the mouth | Other | Action Observation Therapy Group: |
| Conventional physiotherapy groupParticipants will receive treatment for 16 sessions in total, with 2 sessions per week for 8 weeks. Each session will last 50 minutes. Conventional physiotherapy training will be structured according to the child's symptoms and needs, and will consist of stretching, strengthening, normal walking training, postural control training, and weight-bearing training in different positions (sitting, standing, side-lying, prone). | Other | Conventional physiotherapy group |
Primary outcome
ABILHAND-Kids
Time frame: 0th week; 8th week
Manual ability in daily activities assessed using the ABILHAND-Kids questionnaire for children with cerebral palsy (measured as logit score using Rasch analysis). ABILHAND-Kids evaluates the child's perceived difficulty in performing daily bimanual activities, such as dressing (buttons, zippers), eating with utensils, using scissors or pencils, opening containers, handling small objects. Contains a list of everyday manual tasks Each item is rated based on difficulty: Impossible, difficult, easy. Higher scores indicate better manual ability. Time Frame: 8 weeks
6 secondary outcomes
Pediatric Quality of Life Inventory (PedsQL)
Time frame: 0th week; 8th week
Jebsen-Taylor Hand Function Test
Time frame: 0th week; 8th week
The Child and Adolescent Scale of Participation (CASP)
Time frame: 0th week; 8th week
Gross Motor Function Measure (GMFM)
Time frame: 0th week; 8th week
Timed Up and Go Test
Time frame: 0th week; 8th week
Five Times Sit-to-Stand Test
Time frame: 0th week; 8th week
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 May 2026.
- Background: PubMed 24237279Steenbergen B, Jongbloed-Pereboom M, Spruijt S, Gordon AM. Impaired motor planning and motor imagery in children with unilateral spastic cerebral palsy: challenges for the future of pediatric rehabilitation. Dev Med Child Neurol. 2013 Nov;55 Suppl 4:43-6. doi: 10.1111/dmcn.12306.
- Background: PubMed 23886886Sgandurra G, Ferrari A, Cossu G, Guzzetta A, Fogassi L, Cioni G. Randomized trial of observation and execution of upper extremity actions versus action alone in children with unilateral cerebral palsy. Neurorehabil Neural Repair. 2013 Nov-Dec;27(9):808-15. doi: 10.1177/1545968313497101. Epub 2013 Jul 25.
- Background: PubMed 32982541Alamer A, Melese H, Adugna B. Effectiveness of Action Observation Training on Upper Limb Motor Function in Children with Hemiplegic Cerebral Palsy: A Systematic Review of Randomized Controlled Trials. Pediatric Health Med Ther. 2020 Sep 15;11:335-346. doi: 10.2147/PHMT.S266720. eCollection 2020.
- Background: PubMed 38512713Demeco A, Molinaro A, Ambroggi M, Frizziero A, Fazzi E, Costantino C, Buccino G. Cognitive approaches in the rehabilitation of upper limbs function in children with cerebral palsy: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2024 Jun;60(3):445-457. doi: 10.23736/S1973-9087.24.08288-1. Epub 2024 Mar 21.
- Background: PubMed 23232157Shin YK, Lee DR, Hwang HJ, You SJ, Im CH. A novel EEG-based brain mapping to determine cortical activation patterns in normal children and children with cerebral palsy during motor imagery tasks. NeuroRehabilitation. 2012;31(4):349-55. doi: 10.3233/NRE-2012-00803.
- Background: PubMed 30123250Buccino G, Molinaro A, Ambrosi C, Arisi D, Mascaro L, Pinardi C, Rossi A, Gasparotti R, Fazzi E, Galli J. Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study. Neural Plast. 2018 Jul 4;2018:4843985. doi: 10.1155/2018/4843985. eCollection 2018.
- Individual participant dataSharing planned: Yes. IPD will be made available upon reasonable request after publication of the study results. Requests will be evaluated and approved by the principal investigator to ensure that the proposed use is methodologically sound and in accordance with ethical and institutional regulations. Data will be shared for academic and non-commercial research purposes only.
Related trials for Cerebral Palsy (CP)
Recruiting
Additional Effects on tDCS With AOT on Lower Limb Functions on Children With Diplegic CP
Diplegic Cerebral Palsy
Recruiting
Comparison of Vestibular Stimulation and Core Stability Training on Sitting Balance in Hypotonic CP
Hypotonic Cerebral Palsy
Not yet recruiting
Video-based Visual Feedback Combined With Task-oriented Physiotherapy Among Cerebral Palsy
Cerebral Palsy (CP)
RecruitingObservational study
Turkish Translation, Cross-Cultural Adaptation, Validity, and Reliability of the ABILHAND-Kids Young CP Scale
Cerebral Palsy
Active, not recruiting
Local Vibration for Drooling in Children With Cerebral Palsy
Cerebral Palsy (CP)
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.
Hasan K. Alptekin, Prof. Dr. study chair
Bahçeşehir University
Pelin Pisirici, Assoc. Prof. study director
Bahçeşehir 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 motor imagery, Action observation therapy and Conventional physiotherapy group in people with Cerebral Palsy (CP), run by Bahçeşehir University at 1 site in Turkey (Türkiye).
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 7 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 28 May 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 Turkey (Türkiye). 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Betul Unal (+905314070105, betul.unal1@bahcesehir.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
ABILHAND-Kids (time frame: 0th week; 8th week). 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 NCT07612371, which also lists 6 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 28 May 2026.