Comparison Between Schroth AND Klapp Method On Postural Stability AND Trunk Rotation Angle In CP Children With Scoliosis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 22
- 试验地点
- 1
- 主要终点
- Posture and Postural Ability Scale (PPAS)
研究概览
简要总结
Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. Approximately one-third of children with CP are non-ambulant and subsequently spend prolonged periods of time in sitting or lying. Non-ambulatory patients with cerebral palsy (CP) bear a high risk of developing simultaneous progressive scoliotic spine deformities, loss of sitting balance and hip subluxation/dislocation.Treatments for the Spinal deformities associated with cerebral palsy are Schroth method. It is a scoliosis-specific exercise approach that uses postural, scoliosis-specific sensorimotor exercises. While another treatment approach Klapp method aimed to stretch and strengthen muscles by all fours positions, easily applied and that can be used in small groups.
A Randomized clinical trial will be conducted through convenient sampling. Inclusion criteria of this study is age between 8 to 12 years of either gender, with GMFCS level I and II and Trunk rotation angle (ATR) > 4 degree, who are able to understand and follow verbal instructions. Those patients who has been prescribed brace treatment, has scheduled or undergone any corrective surgical treatment of the spine before or during data collection process will be excluded. Patients who are unable to participate, or are reluctant to receive treatment are excluded. Study will be conducted on 22 patients who will be randomly allocated into two groups. One group will receive Schroth exercises. It consists of passive and active postural auto-correction exercises done repeatedly and based on kinesthetic and sensorimotor principles. While the other group with Klapp method includes stretching and strengthening muscles by all fours positions. Bunnell's scoliometer, Adams forward bend test, and Posture and postural ability scale (PPAS) will be used as outcome measure.
详细描述
Group A is Schroth Group (SG). The patients in the Schroth exercise group will start their exercise program under physiotherapist supervision. Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks. Schroth exercises will be performed in an asymmetric position to maximize correction to achieve trunk symmetry. These exercises include spinal elongation, de-rotation, de-flexion, stretching, strengthening and rotational breathing exercises to maintain vertebral alignment. The participants will be asked to combine these exercises with their daily living activities (ADLs). During the Schroth exercises, rice bags, foam blocks, a stool, and long sticks will be used to adjust the posture and give passive support. Exercises are progressed from lying, sitting, or standing positions and from most to least passive support per a review of the quality of the performance. Decreasing the amount or degree of passive support, changing the patient's position, and adjusting the sets and repetitions of exercises will depend on the patient's improvement in exercise performance Group B is Klapp group (KG).The patients in the Klapp exercise group will be treated with supervised klapp exercises. Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks. In each session, a sequence of 8 postures of Klapp Exercises will be carried out. Each posture will be maintained for 4-5 minutes with rest breaks when needed. Positions that will be held are: 1) Lateral crawl, 2) Horizontal sliding, 3) Crawl posture near the ground, 4) Bunny hopping, 5) Arm turn, 6) Big arch, 7) Lateral crawl near the ground, 8) Big curve
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
Participants will get separate treatment protocols and possible efforts will be put to mask the both group about the treatment.
入排标准
- 年龄范围
- 8 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •8 to 12 years of age
- •Either gender.
- •The level of gross motor function between levels I and II in accordance with the gross motor function classification system (GMFCS) .
- •Angle of Trunk Rotation (ATR) > 4 degree .
- •Ability to understand and follow verbal instructions
排除标准
- •Patients will be excluded if they have had been prescribed brace treatment
- •Has received any previous corrective or surgical treatment of the spine
- •Unable to participate, or are reluctant to receive treatment
研究组 & 干预措施
Schroth Exercise. Group A receive Schroth Exercises.
Group A: Schroth Group (SG). The patients in the Schroth exercise group will start their exercise program under physiotherapist supervision. Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks. These exercises include spinal elongation, de-rotation, de-flexion, stretching, strengthening to maintain vertebral alignment.The participants will be asked to combine these exercises with their daily living activities (ADLs).During the Schroth exercises, rice bags, foam blocks, a stool, and long sticks will be used to adjust the posture and give passive support.Exercises are progressed from lying, sitting, or standing positions and from most to least passive support per a review of the quality of the performance.Decreasing the amount or degree of passive support, changing the patient's position, and adjusting the sets and repetitions of exercises will depend on the patient's improvement in exercise performance
干预措施: Schroth Exercises (Other)
Klapp Exercise. Group B receive Klapp Exercises.
Group B: Klapp group (KG). The patients in the Klapp exercise group will be treated with supervised klapp exercises.Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks.In each session, a sequence of 8 postures of Klapp Exercises will be carried out.Each posture will be maintained for 4-5 minutes with rest breaks when needed.Positions that will be held are: 1) Lateral crawl, 2) Horizontal sliding, 3) Crawl posture near the ground, 4) Bunny hopping, 5) Arm turn, 6) Big arch, 7) Lateral crawl near the ground, 8) Big curve
干预措施: Klapp Exercises (Other)
结局指标
主要结局
Posture and Postural Ability Scale (PPAS)
时间窗: 6 weeks
An assessment tool for measuring the quality of postures as well as classifying the ability to maintain and manipulate postures.The Posture and Postural Ability Scale (PPAS) is used to assess supine, prone, lying and sitting posture in the frontal and sagittal planes. The scale ranges from full symmetry to total asymmetry. Similarly, their ability to change or maintain position was rated according to the levels of PPAS ranging from "Able to move into and out of position independently" (level 7) to "Unplaceable in an aligned position" (level 1).The PPAS has excellent inter-rater reliability and validity for children and adults with CP
Bunnell's Scoliometer
时间窗: 6 weeks
Trunk rotation angle (ATR) will be evaluated using Bunnell's scoliometer and Adam's forward bend test. For patients with scoliosis, a landmark for measuring the angle of trunk rotation will be marked on the protruding area during the forward bending test using a scoliometer. For measuring the angle of trunk rotation of scoliosis patient, in order to set the reference point of the scoliometer, the scoliometer is placed on the floor and focused. In the forward bending test, the angle of trunk rotation is measured using a scoliometer on the area to be measured marked with a sticker. The measured value will be read and recorded. The inter-rater reliability according to the measurement method with Scoliometer measurement method 0.971. The scoliometer measurement method has the highest validity (r=0.976)
次要结局
未报告次要终点