Effect of Plyometric Training Cross Education on Strength, Selective Motor Control and Balance in Children With Hemiplegic Cerebral Palsy

Обзор

The goal of this clinical trial is to evaluate the effect of plyometric training with cross-education on lower limb muscle strength, selective motor control, and balance in children with hemiplegic cerebral palsy (HCP). It will also assess the safety and feasibility of applying this training program in pediatric rehabilitation. The main questions it aims to answer are: Does plyometric training with cross-education improve lower limb muscle strength in children with HCP? Does it improve selective motor control in the affected lower limb? Does it improve balance in children with HCP? Researchers will compare a study group receiving conventional physiotherapy plus plyometric training applied to the less affected limb to a control group receiving conventional physiotherapy only. Participants will: Receive treatment for 12 weeks (2 sessions per week) Attend regular physiotherapy sessions including stretching, strengthening, balance, and gait training Participate in plyometric exercises (study group only) Be assessed before and after the intervention using standardized tests for muscle strength, selective motor control, and balance

Подробное описание

This study will be conducted as a randomized controlled clinical trial to investigate the effect of unilateral plyometric training with cross-education on lower limb muscle strength, selective motor control, and balance in children with hemiplegic cerebral palsy (HCP).

Hemiplegic cerebral palsy is a non-progressive neurological disorder caused by early brain injury, resulting in unilateral motor impairment, muscle weakness, and balance dysfunction. The cross-education effect refers to the transfer of strength and motor improvements from a trained limb to the contralateral untrained limb, primarily mediated by central neural mechanisms.

A total of forty children diagnosed with HCP will be recruited from outpatient pediatric clinics affiliated with the Faculty of Physical Therapy, Cairo University. Eligible participants will be randomly allocated into two equal groups.

The study group will receive a conventional pediatric physiotherapy program combined with a structured progressive plyometric training program applied exclusively to the less affected lower limb. The control group will receive only the conventional physiotherapy program, which includes stretching exercises, active and resistive range of motion exercises, balance training, and gait training.

The intervention will be carried out over a period of twelve weeks, with two sessions per week, each lasting approximately one hour. The plyometric training will be designed to progressively challenge neuromuscular performance through exercises involving the stretch-shortening cycle, while the conventional program will focus on functional motor rehabilitation.

Allocation will be performed using a computer-generated block randomization method, and concealment will be ensured using sealed opaque envelopes. The study will adhere to CONSORT guidelines for randomized controlled trials to ensure methodological rigor and transparency.

Outcome measures will be assessed at baseline and post-intervention using standardized and validated tools to evaluate changes in muscle strength, selective motor control, and balance. Data analysis will be performed to determine the effectiveness of the intervention.

Вмешательства

• Другое Conventional Physiotherapy
  Stretching, strengthening, balance, and gait training program.
• Другое Plyometric training
  The plyometric training program will be applied to the less affected lower limb and is designed to enhance neuromuscular performance, explosive strength, proprioception, and motor coordination through rapid eccentric-concentric muscle actions. Each training session will begin with a 5-minute warm-up to prepare the child physically and psychologically for exercise. The main training phase will include progressive plyometric exercises targeting lower limb function. A 5-minute cool-down period wil

Первичные конечные точки

• Lower Limb Muscle Strength [Срок оценки: 12 weeks]
• Selective Motor Control (SMC) [Срок оценки: 12 weeks]
• Balance [Срок оценки: 12 weeks]

Критерии участия

Inclusion Criteria:Children eligible for participation in this study must meet all the following criteria:

• Diagnosed with HCP by a pediatric neurologist.
• Age range 6 and 10 years old.
• Their grade of spasticity level 1 or 1+ according to MAS.
• Their gross motor function level is I, II on GMFCS.
• Able to follow verbal instructions and cooperate during assessment and training.

Exclusion Criteria:Children will be excluded from this study if they have any of the following:

• Presence of corrective neurological/musculoskeletal surgery of the lower limb in the previous year or botulinum toxin injections of the lower limb within the previous 6 months.
• Presence of visual or auditory impairments that would affect balance performance.
• Uncontrolled epileptic seizures or recent medication changes

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Египет · 3 центра

• Cairo University — Giza
• Faculty of physical therapy Cairo University — Cairo
• Physical therapy Cairo University — Giza

Идентификаторы

NCT: NCT07669857 · P.T.REC/012/006103

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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