Effects OF NMES With and Without Dynamic Bracing on Spasticity and Movement Quality in CP

Not Applicable

Recruiting

Interventions: Other: NMES without Dynamic Bracing
Other: NMES with Dynamic Bracing
Other: Dynamic Bracing Only

Brief Summary: The study aims at comparing Neuromuscular electrical Stimulation with and without dynamic bracing on spasticity and movement quality of lower limb in Children with Cerebral Palsy

Detailed Description: Cerebral palsy (CP) is a lifelong motor impairment caused by an early brain injury and affects 2-3 per 1,000 live births. It is a complex medical condition that negatively impacts cognition, language, sensations, movement, and gait patterns. It is normally carried out using a comprehensive approach that incorporates numerous approaches targeted at minimizing symptoms and improving functional outcomes.

NMES (Neuromuscular and Muscular Electrical Stimulation) is an instrument that provides electrical impulses to nerves, causing muscles to contract, while dynamic bracing use muscle power to pre-compress soft tissue to produce the high forces required to control specific pathological diseases.

The hip adductors, the knee flexor muscles, and the ankle and foot muscles (gastrocnemius and soleus may experience increased tone, causing the ankles to be held in a plantar-flexed (pointed downward) position) are targeted with NMES in the lower extremity to reduce the spasticity \& improve the quality of movement in CP children. Investigating how combining NMES with dynamic bracing benefits lumbar disc bulge patients adds to the growing body of evidence supporting multimodal treatment.

Recruitment & Eligibility

Inclusion Criteria

Age between 5 to 12 years.
Able to walk with or without an assistive device. Classification as level I-II on the Gross Motor Functional Classification System (GMFCS).
Able to stand with or without support for 1 minute.
Classification as levels I-III on the Manual Ability Classification System (MACS); and the ability to follow and accept verbal instructions.
Muscle tone scored ≥2, according to Modified Ashworth Scale.

Exclusion Criteria

Orthopedic Surgical intervention (e.g. tendon lengthening in lower limb) within the previous 12 months
Treatment with botulinum toxin in the calf muscles within the previous 6 months
Presence of structural deformities at the lower limbs and trunk, or instability in the ankle joint, which could compromise the child's safety and performance of the motor task
Severe affective or psychiatric impairments;
Serious vision or hearing problems
Any neurological impairment (epilepsy or any other disease that would interfere with physical activity)

Arm && Interventions

Group	Intervention	Description
NMES without Dynamic Bracing	NMES without Dynamic Bracing	Neuromuscular Electrical Stimulator targeting the lower extremity
NMES with Dynamic Bracing	NMES with Dynamic Bracing	The NMES targeting the hip adductors, the knee flexor muscles and the ankle \& foot muscles, along with dynamic bracing
Dynamic Bracing Only	Dynamic Bracing Only	Dynamic Bracing of lower extremity

Primary Outcome Measures

Name	Time	Method
Modified Ashworth Scale	6 weeks	The scale is used to measure spasticity
Observable Movement Quality Scale	6 weeks	it is used assess the movement quality in children
Physicians Rating Scale	6 weeks	it is used to objectively documenting the hip, knee, ankle and foot changes in children with CP.

Secondary Outcome Measures

Name	Time	Method

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