Stretch-Shortening Cycle Exercise: Potential Implications For Children With Obstetric Brachial Plexus Injury

Not Applicable

Completed

• Conditions: Erb Palsy
• Interventions: Other: Standard exercise program; Other: Stretch-shortening exercise

• Registration Number: NCT06157476
• Lead Sponsor: Cairo University

Brief Summary

This study was set out to evaluate the effect of a 12-week stretch-shortening cycle exercise (SSC-Ex) on muscle strength, bone mineral density, and upper extremity function in children with obstetric brachial plexus injury (OBPI). Fifty-six patients with OBPI were randomly allocated to the SSC-Ex group (n = 28, received SSC-Ex program, twice/week, over 12 weeks) or the control group (n = 28, received standard exercise program). Both groups were assessed for muscle strength, bone health, and upper extremity function before and after treatment.

Detailed Description

Fifty-six children with OBPI were recruited from the Physical Therapy Outpatient Clinic of Prince Sattam Bin Abdulaziz University and three referral hospitals in Riyadh provenience, Saudi Arabia. The study included children who had a confirmed diagnosis of upper arm type of OBPI, classified as level I or II per Narakas classification system, aged 10-16 years, had a functional level of grade III according to the Mallet scoring system, and were consuming a balanced diet. Children who had a history of corrective neuromotor or musculoskeletal surgery, shoulder dislocation/subluxation, calcium supplements, or cognitive issues were excluded.

Outcome measures

1. Muscle strength: The peak isometric muscle strength of the shoulder flexors, abductors, external rotators, elbow flexors, and extensors was measured using a hand-held dynamometer.

2. Bone mineral properties: Bone mineral density and bone mineral content of the humeral, radial, and ulnar shafts were measured through Dual-Energy X-ray Absorptiometry (DEXA) scanning.

3. Upper-extremity function: The functional performance was assessed using the brachial plexus outcome measure (BPOM) activity scale.

The SSC-Ex group received a 12-week therapist-led SSC-Ex training, for approximately 35 minutes per session, two times a week for 12 consecutive weeks, in conformity with the National Strength and Conditioning Association guidelines and American Academy of Pediatrics safety standards. The SSC-Ex program consisted of ten unilateral and bilateral upper extremity exercises in the form of push-ups and ball slams/throws/passes activities. The SSC-Ex program preceded with a warm-up for 5 minutes and ended with a cool-down for 5 minutes. The control group received the standard exercise program, 35 minutes per session, two times a week for 12 consecutive weeks. The program consisted of flexibility exercises, strength training, weight-bearing exercises, proprioceptive neuromuscular facilitation, manual guidance, and functional training.

Study Timeline

• Study Start: 2021-03-14
• Primary Completion: 2022-06-23
• Study Completion: 2022-06-23
• Status Verified: 2023-11
• Study First Submitted: 2023-11-27
• Study First Submitted QC: 2023-11-27
• Last Update Submitted: 2023-11-27
• Study First Posted: 2023-12-05
• Last Update Posted: 2023-12-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 56

Inclusion Criteria

• Confirmed diagnosis of upper arm type of OBPI.
• Narakas classification level I or II.
• Functional level of grade III per the Mallet scoring system.
• Age between 10-16 years.

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Exclusion Criteria

• History of neuromotor or musculoskeletal surgery.
• Shoulder subluxation/dislocation.
• Past fracture involving the upper extremities.
• Calcium supplement intake.
• Inability to adhere to the scheduled program.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control group	Standard exercise program	Children in this group received the standard exercise program.
SSC-Ex group	Stretch-shortening exercise	Children in this group received the SSC-Ex program

Primary Outcome Measures

Name	Time	Method
Muscle strength	2 months	The peak isometric muscle strength (Kg) was measured using a hand-held dynamometer.
Bone mineral density	2 months	The amount of bone mineral divided by the bone scanned area (gm/cm2). It was assessed within the humeral, radial, and ulnar shafts using DEXA scanning.
Bone mineral content	2 months	It is the amount of bone mineral in bone tissue (g/cm). It was calculated by summing the bone mineral density values over the projected area. It was also measured within the humeral, radial, and ulnar shafts using DEXA scanning.

Secondary Outcome Measures

Name	Time	Method
Functional performance	2 months	The affected arm functionality was assessed using the brachial plexus outcome measure. activity scale \[an 11-item performance-based measure with five-point ordinal ratings for each item (I = cannot complete the task and 5 = complete the activity with normal pattern); higher scores denote better performance, with 55 being the maximum attainable score\].

Trial Locations

Locations (1)

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