Effect of Different Stretching Techniques

Not Applicable

Completed

• Conditions: Cerebral Palsy
• Interventions: Other: PNF stretching; Other: Static stretching group

• Registration Number: NCT06608693
• Lead Sponsor: Gazi University

Brief Summary

The aim of this study is to investigate the effect of proprioceptive neuromuscular facilitation (PNF) and static stretching techniques on the balance and functional capabilities of children diagnosed with diplegic cerebral palsy (CP).

Detailed Description

The aim of this study is to investigate the effect of proprioceptive neuromuscular facilitation (PNF) and static stretching techniques on the balance and functional capabilities of children diagnosed with diplegic cerebral palsy (CP). The study consisted of a group of sixteen children, ranging in age from 8 to 16 years, who were diagnosed with bilateral hip flexor contracture and diplegic cerebral palsy. These children were classified according to the Gross Motor Function Classification System (GMFCS) levels I to III. The children were randomly divided into PNF and static stretching groups. Stretching techniques were applied 2 days a week for 4 weeks, with 6 repetitions in each session. The study assessed various parameters, including hip extension range of motion (ROM), muscle tone intensity based on the Modified Ashworth Scale, hip flexor shortness as determined by the Thomas Test, the time up and go (TUG) test, balance using the Pediatric Berg Balance Scale, and functional status evaluated through the Gilette Functional Walking Assessment Questionnaire.

Study Timeline

• Study First Submitted: 2024-09-12
• Study First Submitted QC: 2024-09-19
• Study First Posted: 2024-09-23
• Study Start: 2024-09-27
• Primary Completion: 2024-12-27
• Study Completion: 2024-12-29
• Status Verified: 2025-01
• Last Update Submitted: 2025-01-17
• Last Update Posted: 2025-01-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 34

Inclusion Criteria

• A clinical diagnosis of CP;
• Age ranging from 6 to 18 years;
• No recent administration of Botulinum Toxin to the lower extremity muscles in the last 6 months;
• An IQ score of 70 or above;
• A Gross Motor Function Classification System (GMFCS) value of 1, 2 or 3;
• Presence of hip flexion contracture;
• Willingness to participate in the study

Exclusion Criteria

• Concomitant diagnoses aside from CP,
• Presenting with muscle tone ratings of 3 or 4 in the hip muscles according to the Modified Ashworth Scale (MAS),
• Who had undergone tendon lengthening surgery to increase hip flexion

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
PNF stretching group	PNF stretching	PNF and static stretching methods were applied 2 days a week and 6 repetitions in each session for 4 weeks to the hip flexors. In addition to stretching, both of the groups received a routine treatment program consisting of gluteus maximus and quadriceps strengthening, balance, and walking exercises.
Static stretching group	Static stretching group	PNF and static stretching methods were applied 2 days a week and 6 repetitions in each session for 4 weeks to the hip flexors. In addition to stretching, both of the groups received a routine treatment program consisting of gluteus maximus and quadriceps strengthening, balance, and walking exercises.

Primary Outcome Measures

Name	Time	Method
Hip extension Range of motion in degrees	3 months	Hip extension ROM was measured with a digital goniometer while the patient was lying in the prone position, and the knee was flexed.
Thomas test	3 months	The degree of hip flexion contracture was determined using the Thomas test while the patient was supine. The opposite hip was passively moved in the flexion direction as much as possible by a second physiotherapist. In the meantime, the degree of hip flexion on the designated side was assessed using a digital goniometer and documented in degrees. This test was repeated 3 times, and the results were averaged.
Timed Up and Go test (TUG)	3 months	Functional status was assessed by the Timed Up and Go test (TUG). The time required for the patient to get up from the chair, walk 3 meters, turn around, walk back to the chair, and sit down was calculated in seconds. The test was repeated 3 times, and the data average was recorded.
The Pediatric Berg Balance Scale (PBBS)	3 months	The Pediatric Berg Balance Scale (PBBS) was used to evaluate dynamic balance skills in children with CP. The scale comprises 14 items including sitting balance,standing balance, sitting to standing/standing to sitting, transfers, stepping, reaching forward with outstretched arm, reaching the foor, turning, and placing foot on stool items. Each item ranked from 0 to 4. 0 shows inability to perform the instruction, while 4 shows the ability to perform without any difculty. Maximum total score is 56.
Gilette Functional Assessment Questionnaire (FAQ)	3 months	Gillette Functional AssessmentQuestionnaire (FAQ) 22-item asks the respondent to 'Please ratehow easy it is for the patient to do the following activities'followed by brief descriptions of 22 locomotor skills the five-level (minumum:1, maximum:5) Likert response scale used for the 22 skill items was 'easy', 'a little hard', 'very hard', 'can't do at all',and 'too young for activity'.
Age in years	3 months	Age of patients will be recorded
Weight in kilograms	3 months	Weights of patients will be recorded
Height in meters	3 months	Heights of patients will be recorded

Trial Locations

Locations (1)

Gazi University; 🇹🇷 Ankara, Emniyet Mahallesi Bandırma Caddesi, Turkey