Clinical Research Directory

Inclusion Criteria: * Age 6-17 years * Diagnosis of Bilateral CP: diplegia, triplegia, or quadriplegia * Gross Motor Function Classification Systems-Expanded \& Review (GMFCS) levels III or IV * Ability to sit 5s with trunk support between mid-ribs and pelvis (SATCo = 3-7) * Cognitive capacity to follow basic verbal instructions (i.e., "do not put your hands on your lap" or "follow and reach the toy") Exclusion Criteria: * Absent head control (SATCo = 1) * Current medical illness unrelated to CP at the time of the study * Severe dyskinesia that prevents the child from maintaining sitting and recovering balance during reaching movements * History of recurrent seizures (daily) or drug-resistance epilepsy * Severe Spinal Deformities: scoliosis \>40◦ and/or kyphosis \>45◦ * Spinal osteosynthesis or orthopedic surgery of spine, upper or lower extremities in the last 6 months * Severe spasticity of biceps/triceps in both upper extremities (Modified Ashworth Scale = 4) * Local chemodenervation therapy in spastic muscles (e.g., botulinum toxin or phenol injections) in upper or lower extremities in the previous 3 months or planned during the study * Other major surgeries in the previous 6 months (if medically contraindicated)