The Role of Pilates, Plyometrics, and Their Combination for Children With Unilateral Cerebral Palsy

Not Applicable

Completed

• Conditions: Cerebral Palsy
• Interventions: Other: Plyometric-based Muscle Loading Exercises; Other: Pilates-based Core Strengthening Exercises; Other: Combined Pilates and Plyometrics

• Registration Number: NCT05429281
• Lead Sponsor: Cairo University

Brief Summary

This study was conducted to compare the effect of Pilates-based core strengthening (PsCS) and plyometric-based muscle loading (PlyoML) and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP were randomly allocated to the PsCS (n = 27), PlyoML (n = 27), or combined intervention (n = 27) group. Participants in the three groups were assessed for postural control, balance, and mobility on the pre and post-treatment occasions.

Detailed Description

Eighty-one children with ULCP were recruited from the Physical Therapy Outpatient Clinic of College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, King Khalid Hospital, and a tertiary referral hospital, Al-Kharj, Saudi Arabia. Their age ranged between 12 and 18 years, were functioning at levels I or II according to the Gross Motor Function Classification System, and had spasticity levels 1 or 1+ per the Modified Ashworth Scale. Children were excluded if they had fixed deformities, underwent neuromuscular or orthopedic surgery in the last 12 months, submitted to BOTOX injection in the past 6 months, had attentional neglect, and if they had cardiopulmonary problems preventing them from performing high-intense exercise training.

Outcome measures

* Postural control: The directional dynamic limit of stability (forward, backward, paretic, and non-paretic) and overall limit of stability were assessed using the Biodex balance system.

* Balance and mobility: The Community Balance and Mobility Scale (CB\&M), Functional Walking Test (FWT), and Timed Up and Down Stair test (TUDS) were used to quantify balance and mobility capacity.

Interventions

All groups were trained for 45 minutes, twice per week, for 12 successive weeks. The PsCS group performed eight Pilates exercises geared predominantly toward the core muscles. The PlyoML group performed 10 plyometric exercises primarily focused predominantly on the lower body. The combined group combined the same exercises as the PsCS and PlyoML groups, although with half the number of sets/repetitions.

Study Timeline

• Study Start: 2021-02-07
• Primary Completion: 2022-04-28
• Study Completion: 2022-04-28
• Status Verified: 2022-06
• Study First Submitted: 2022-06-18
• Study First Submitted QC: 2022-06-18
• Last Update Submitted: 2022-06-18
• Study First Posted: 2022-06-23
• Last Update Posted: 2022-06-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 81

Inclusion Criteria

• Unilateral cerebral palsy
• Age 12-18 years
• Motor function level I or II according to the Gross Motor Function Classification System.
• Spasticity level 1 or 1+ according to the Modified Ashworth Scale

Exclusion Criteria

• Structural deformities/contractures
• Musculoskeletal or neural surgery in the last year
• BOTOX injection in the last 6 months.
• Cardiopulmonary disorders interfere with the ability to engage in exercise training.
• Perceptual and/or behavioral disorders.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Plyometric-based Muscle Loading Group	Plyometric-based Muscle Loading Exercises	Participants in this group performed 10 PlyoML exercises primarily focused on the lower body.
Pilates-based Core Strengthening Group	Pilates-based Core Strengthening Exercises	Participants in this group performed eight PsCS exercises geared predominantly to the core muscles.
Combined training group	Combined Pilates and Plyometrics	Participants in this group performed the same exercises as the PsCS and PlyoML groups, although with half the number of sets/repetitions.

Primary Outcome Measures

Name	Time	Method
Limit of postural stability	2 months	The capacity to control and move the center of gravity in various directions across their base of support was assessed utilizing the Biodex balance system. Values are expressed as accuracy % and higher scores mean better balance capability.

Secondary Outcome Measures

Name	Time	Method
Functional Walking Test	2 months	The Functional Walking Test is a valid and reliable measure for assessing functional waking capacity in ambulant children with cerebral palsy. The test consists of 11 items including kneel walking, transitions to standing, incline walking, ascending/descending stairs, and walking a narrow beam, all of which focus on the postural control and balance components of walking. The maximum score is 23 and higher scores indicate better walking capacity
Community Balance and Mobility Scale	2 months	Community Balance and Mobility Scale is a performance-based measure assessing high-level balance capabilities while also addressing the speed and coordination components necessary for the ordinary community function.; The scale consists of 13 items. Item scores range from zero (complete inability of task execution) to five (the most successful task completion), and the maximum possible score is 96. A higher score indicates better performance.
Timed Up and Down Stair test	2 months	The Timed Up and Down Stairs test measures the time (in seconds) that the children take to go up a 14-step stair flight (each step was 20 cm in height), turn around, and come back down. Shorter time indicates better performance.

Trial Locations

Locations (1)

Ragab K. Elnaggar; 🇸🇦 Al Kharj, Riyadh, Saudi Arabia