Randomized Controlled Trial of Early Intensive Leg Exercise to Improve Walking in Children With Diplegia

This study is testing whether early, intensive leg exercise therapy — starting in infancy — can improve walking ability in young children with spastic diplegia, a form of cerebral palsy where both legs are affected due to premature brain injury. The window of early life is critical for motor learning because the brain is highly plastic (adaptable), and early intensive therapy may help children develop stronger walking patterns before compensatory habits set in. Very young children (8 to 36 months) with periventricular white matter injury from premature birth will participate in a structured intensive leg exercise program. Progress will be tracked over time with gait analysis and motor assessments. You may be eligible if: - Your child is between 8 and 36 months of age - Your child has bilateral lower limb motor impairment - Your child has periventricular white matter injury from prematurity - Your child is able to stand with some support You may NOT be eligible if: - Your child has significant upper limb involvement (MACS level 3 or higher) - Your child has uncontrolled epilepsy or infantile spasms in the past 6 months - Your child has cardiovascular or musculoskeletal conditions that prevent intensive exercise - Your child has received botulinum toxin (Botox) injections in the legs within the past 6 months Talk to your doctor to see if this trial is right for you.