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Effect of Task-oriented Circuit Training on Gait Kinematics, Pelvic Symmetry and Endurance in Children With Hemiplegia

Not Applicable
Completed
Conditions
Cerebral Palsy, Spastic
Interventions
Other: Selected Physical therapy program
Other: Task-oriented circuit training
Registration Number
NCT04761263
Lead Sponsor
Horus University
Brief Summary

Statement of the problem:

Does task-oriented circuit training have an effect on kinematic parameters of gait, pelvic symmetry and trunk endurance in children with hemiplegic CP?

Purpose of the study:

This study aims to:

* Investigate the effect of exercise-based task-oriented circuit training on gait kinematics including (Stride length, step length, cadence, walking speed, ankle dorsiflexion angle in initial contact, knee extension angle in midstance and hip extension angle in terminal stance) in children with hemiplegic CP.

* Determine the effect of task-oriented circuit training on pelvic symmetry including (Anterior and lateral pelvic tilting) in children with hemiplegic CP.

* Examine the effect of task-oriented circuit training on trunk endurance including (prone plank test, timed partial curl up test, front abdominal power test and unilateral supine bridge test) in children with hemiplegic CP.

Detailed Description

Children with CP have lowered physical fitness levels because their motor impairments restrict their participation in daily physical activities. Children with hemiplegic CP may experience a variety of concomitant health conditions including, movement difficulty, postural and balance instability, muscle spasticity, difficulty with motor planning and control, and cognitive impairments. They also have diminished force generation, debilitated proprioception around the core, lack of enough harmonization in core musculature, and diminished capacity to adjust coupling between the trunk, pelvis, and hip stabilizers leading to diminished proficiency of movement.

According to the concept of motor learning, training is considered to be most effective when the training task is specific to the intended outcome, as optimal improvement in function involves the practice of task-specific activities. Due to the shift in focus on functional movements rather than muscle activity or movement patterns, there has been a task-oriented approach which is based on the system model of motor control providing motivation due to specific achievements that can be made.

Task-oriented circuit training effectively provides various sensory stimulation and promotes functional activities for stroke patients; however, more attention is becoming directed to children with CP to examine the effect of the task-oriented circuit training program on functional performance in children with CP. Therefore, the aim of this study is to determine the effect of rehabilitation delivered as a task-oriented circuit exercise program on kinematic parameters of gait, pelvic symmetry, and trunk endurance in children with hemiplegic CP.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Their age will be ranged from 7-10 years.
  • Their motor function will be at level I and II according to Gross Motor Function Classification System GMFCS (Palisano et al., 2008).
  • The degree of spasticity will range from mild to moderate according to Modified Ashworth Scale (Bohannon and Smith, 1987).
  • They will be able to follow instructions during evaluation and treatment.
Exclusion Criteria

Children will be excluded from the study if they have:

  • Other types of cerebral palsy.
  • Cardiovascular or respiratory disorders.
  • Botulinium muscular injection in the last 6 months
  • Surgical interference in lower limbs and/or spine.
  • Muscloskeletal problems or fixed deformities in the spine and/or lower extremities.
  • seizures.
  • Visual or hearing impairment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Selected Physical Therapy groupSelected Physical therapy programwill receive a selected physical therapy program for 90 minutes, 3 times/week for 3 successive months.
Task-oriented circuit training groupSelected Physical therapy programChildren allocated to the study group will receive the same selected physical therapy program given to the control group for 45 minutes in addition to 45 minutes task-oriented circuit training program. The frequency of the whole program will be three times per week, for three months.
Task-oriented circuit training groupTask-oriented circuit trainingChildren allocated to the study group will receive the same selected physical therapy program given to the control group for 45 minutes in addition to 45 minutes task-oriented circuit training program. The frequency of the whole program will be three times per week, for three months.
Primary Outcome Measures
NameTimeMethod
Assessing the change in Pelvic symmetryat baseline and after 3 months of intervention

by using palpation meter inclinometer to measure the change in anterior and lateral pelvic tilting angles in degrees

Assessing the change in Temporal parameters of gaitat baseline and after 3 months of intervention

assessment via using 2D gait analysis by Kinovea software in order to measure change in cadence (number of steps/minute) and walking speed (meter/minute)

Assessing the change in Angular displacement of joints during gait cycleat baseline and after 3 months of intervention

assessment via using 2D gait analysis by Kinovea software in order to measure change in angular displacement of joints during gait cycle including: angle of ankle dorsiflexion at initial contact, angle of knee extension at midstance and angle of hip extension during terminal stance. All of these measurements have the same unit which is (angle in degrees)

Assessing the change in spatial parameters of gaitat baseline and after 3 months of intervention

assessment via using 2D gait analysis by Kinovea software in order to measure change in step length and stride length in centimeters.

Secondary Outcome Measures
NameTimeMethod
Assessing the change in Trunk muscles enduranceat baseline and after 3 months of intervention

Endurance of the trunk muscles will be evaluated using four endurance tests designed to establish the change in isometric trunk muscles endurance including; prone plank test (sec), timed partial curl up test (sec), front abdominal power test (cm) and unilateral supine bridge test (sec). For each trunk endurance measure, the examiner will instruct the child to hold the test position as long as possible prior to all testing. Each position will be tested three times and the average time will be recorded.

Trial Locations

Locations (1)

Outpatient clinic, Faculty of Physical Therapy, Cairo University

🇪🇬

Cairo, Egypt

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