Impaired gait is a common sequela in bilateral spastic cerebral palsy. We compared the effects of two novel research interventions—transcranial direct current stimulation and virtual reality—on spatiotemporal and kinetic gait impairments in children with bilateral spastic CP. Forty participants were randomized to receive either transcranial direct current stimulation or virtual reality training. Both groups received standard-of-care gait therapy during the assigned intervention and for the subsequent 10 weeks afterward. Spatiotemporal and kinetic gait parameters were evaluated at three different times: (i) before starting the intervention, (ii) after two weeks of intervention, and (iii) 10 weeks after intervention completion. Both groups exhibited higher velocity and cadence, as well as longer stance time, step length, and stride length after intervention (p < 0.001). Only the transcranial direct current stimulation group exhibited increased maximum force and maximum peak pressure after intervention (p’s ≤ 0.001), with continued improvements in spatiotemporal parameters at follow-up. The transcranial direct current stimulation group had higher gait velocities, stride length, and step length at follow-up compared to the virtual reality group (p ≤ 0.02). These findings suggest that transcranial direct current stimulation has a broader and longer-lasting effect on gait than virtual reality training for children with bilateral spastic cerebral palsy.

Background: Competency level assessment is essential for physical therapists (PTs) to monitor the acquisition of competency and improve the standards of clinical practice. Objective: To assess and compare competency levels among Egyptian PTs of the governmental health institutions in urban areas. Subjects and Methods: This survey included 574 PTs of Bachelor (BSc); Diploma; Doctor of physical therapy (DPT); Master (MSc); and Doctorate of Philosophy (PhD) holders of both genders. Self-assessment of competency levels was carried out by using Egyptian physical therapists' Competencies Questionnaire (EPTCQ), which consisted of 10 standards represented 51 indicators. The questionnaires were analyzed and computed based upon individual-and profession-related variables. Results: Comparison between different academic categories indicated highly significant differences (p≤0.0001). The lowest percentage of competency level (57.91%) was demonstrated by BSc holders while the highest percentage (86.01%) was reported by PhD holders. There was an incremental increase in the percentage of Diploma (60.80%), DPT (69.65%) and MSc holders (76.95%). Conclusion: Percentage of overall competency levels among Egyptian PTs was 70.27%. Increased mean values in proportion to the levels of academic qualifications were mainly attributed to the nature and depth of academic programs, their co-activities and cumulative experience. These findings are of importance to enhance self-assessment culture and procedures, and to provide a basis for academic programs reform and upgrade in order to improve practice standards and enhance competency of PTs.