Effect of Combined Pulley and Vibration Therapy on Spasticity and Motor Function in Children with Cerebral Palsy and Genu Recurvatum: A Quasi-Experimental Study.

Introduction Cerebral palsy is a non-progressive neurological disorder affecting movement, posture, and muscle tone. Spasticity commonly leads to secondary musculoskeletal deformities such as genu recurvatum, which causes knee hyperextension during gait and negatively affects balance, posture, and functional mobility. Conventional rehabilitation often shows limited effectiveness in simultaneously improving motor function and reducing spasticity. Pulley therapy promotes task-oriented strengthening and motor control, while vibration therapy may reduce spasticity through neuromodulatory effects and improved proprioception. The combination of these therapies in children with genu recurvatum and cerebral palsy, however, is not well documented by research. Methodology A quasi-experimental, single-group pre-post interventional study was conducted at the Department of Pediatric Physiotherapy, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Karad, India. It is acknowledged that the single-group pre-post design limits causal inference; observed improvements may be attributable in part to factors such as natural maturation, concurrent standard physiotherapy, therapist attention, or repeated testing effects rather than exclusively to the combined intervention. Fifteen children diagnosed with spastic cerebral palsy and genu recurvatum, aged between five and 12 years, were recruited through convenience sampling and categorised under Gross Motor Function Classification System (GMFCS) Levels I and III. Eight participants were classified as GMFCS Level I and seven participants as GMFCS Level III. Participants received a multicomponent intervention comprising standard physiotherapy, pulley therapy, and vibration therapy. As all components were delivered simultaneously, the independent contribution of each component could not be isolated.  Results Children with spastic cerebral palsy and genu recurvatum showed statistically significant improvements in gross motor function and decreases in spasticity, according to the combined post-intervention analysis. Gross Motor Function Measure-88 (GMFM-88) scores (dimensionless proportion scores ranging from 0 to 1) improved from 0.690 ± 0.05 to 0.762 ± 0.06, Modified Ashworth Scale (MAS) scores reduced from 1.90 ± 0.38 to 1.40 ± 0.35, and knee hyperextension decreased from 11.00° ± 1.8 to 7.80° ± 1.5 following the 12-week intervention program (p < 0.001). Conclusion In children with cerebral palsy with genu recurvatum, pulley therapy in conjunction with vibration therapy was associated with significant improvements in motor function and spasticity, showing preliminary promise as a rehabilitation strategy for this population. The integrated protocol may help enhance neuromuscular control, functional mobility, and overall physical performance in this population.