Effects of Trunk Stability Exercises on Hand Function in Children With Cerebral Palsy
- Conditions
- Cerebral Palsy
- Interventions
- Other: conservative physiotherapy planOther: trunk stability exercise plan
- Registration Number
- NCT05491863
- Lead Sponsor
- Riphah International University
- Brief Summary
Rationale of this research is to evaluate the outcome of trunk stabilizing exercises on the fine motor skills of subjects with hemiplegic CP. The significance of this study is to identify how much core stability exercises improve hand function. This study will help gather evidence on the practice of core stabilizing exercises to improve hand function so that it can help both physicians and patients.
- Detailed Description
Cerebral palsy is a permanent damage in early brain in fetus which leads to movement disorder. The most frequent reason of bodily incapacity is cerebral palsy in pediatric population. CP children have difficulty maintaining dynamic and static trunk stability, which leads to affect sitting, standing, reaching and walking. Hemiplegic Cerebral palsy patients are challenged by fine motor skills, like gripping or object handling, which are essential for activities of daily life.the purpose of the study was to evaluate the effects of trunk stability exercises on hand function in children with cerebral palsy.It was a randomized, controlled trial, conducted among hemiplegic cerebral palsy patients. Sample size was 26 by using Epitool software. Participants were randomly assigned to the intervention or control group after a baseline assessment with a lottery ticket and an opaque envelope. All participants in both groups were evaluated on three occasions: (i) baseline (ii) post-intervention and (iii) after 4 weeks follow to assess long term effects.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 26
- Both male and female were included
- Age group 6 to 18 years.
- Medical diagnosis of hemiplegic cerebral palsy assured.
- Unilateral Movement deficit (less than 2.5) on amount of use scale on MAL (motor activity log).
- Level 1 to 3 on manual ability classification system (MACS).
- Mild to moderate spasticity of upper extremity (MAS grade 1 to 2.)
- GMCS level I-II.
- Subjects were cognitively capable and competent to follow the instructions
- Patients with altered conscious level.
- Previous surgery or pain in upper limbs.
- Rigid contracture and fixed deformities in the spine
- Auditory / vision problem.
- Previous Botulinum Toxin-A injections in upper limb.
- Cardio-respiratory problem
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description conservative physiotherapy plan trunk stability exercise plan Postural and Proprioceptive facilitation,walking ,jumping and staircase activity Trunk stability exercise plan conservative physiotherapy plan Trunk stability exercises including proprioception,balance and stability. conservative physiotherapy plan conservative physiotherapy plan Postural and Proprioceptive facilitation,walking ,jumping and staircase activity Trunk stability exercise plan trunk stability exercise plan Trunk stability exercises including proprioception,balance and stability.
- Primary Outcome Measures
Name Time Method Trunk Control Meaurment Scale 12 week The trunk control measurement scale measures two mechanism of trunk control throughout functional activities. First level begins with smooth base of support and it ends on dynamic service to assess balance of body.15 items performed with the sub scales that consist of 5, 7 and 3 activities respectively. Total score ranges from 0 to 58 on scale.
ABILHAND-kids (Manual Ability Measure) 12 week ABILHAND-Kids questionnaire is valuable tool to assess a child's unimanual and bimanual upper limb activities. This 21 items hand use scale with total 63 score prestents low to high performance of fine motor .
CHEQ (Children's hand-use experience's questionnaire) 12 weeks Children's Hand-use Experience Questionnaire has been developed to capture kid's perceived quality of performance when using the affected hand in these situations. CHEQ is an internet based questionnaire containing 29 items with (bimanual activities) presented one by one in random order .score ranges from 0 to 100 representing better function with higher score .
- Secondary Outcome Measures
Name Time Method Modified ash worth scale (MAS) 12 weeks The original ash worth scale by Bryan Ashworth was a five point numerical scale that graded spasticity from 0 to 4, with zero being no resistance and 4 being a limb rigid in flexion or extension. In 1987 when while performing a study to exam reliability of manual tests of elbow flexor muscle spasticity, Bohannon and Smith modified the ash worth scale by adding 1+ to scale to increase sensitivity. Since modified ash worth scale has been applied in clinical practice and research as measure/grade muscle spasticity
UE MAL 12 weeks It consists of both the AS and HW scales are used during all test administrations, except for the periodic administrations of MAL during treatment, when only the HW scale is used. In all administrations except those done during treatment, begin with AS scale and ask participants to rate all task using the AS scale first the participant than rates all tasks perform with the HW scale
Manual ability classification system 12 weeks It's a 5 level ordinal classification system which describes the manual ability of children aged 4 to 18 years with cerebral palsy. When children holds objects in typical activities, MACS levels describe the collaborative use of both hands together in daily life activities .As a classification system the purpose of MACS is to discriminate meaningfully on child's manual ability to handle objects in daily living. It's not an outcome measure or diagnostic tool
Trial Locations
- Locations (1)
Rising sun institute for special children
🇵🇰Lahore, Punjab, Pakistan