An interventional study of Plyometric Exercises and Standard Physical Therapy in Cerebral Palsy, sponsored by Cairo University. Completed at 1 site in Saudi Arabia. Open to participants aged 10 Years to 16 Years. Per ClinicalTrials.gov, last updated 2022-03-31.
Sponsored by Cairo University · Not applicable, Interventional, and Treatment
This study was designed to investigate the effect of three months of plyometric exercise training on the mechanical and morphological properties of the plantar flexor muscle-tendon unit in children with unilateral cerebral palsy (UCP). Thirty-eight children with UCP were randomly allocated to the plyometric exercise group (n = 19, underwent a plyometric training program) or the Control group (n =19, received usual physical rehabilitation alone). Both groups were assessed for the plantar flexors' morphological and mechanical properties before and after treatment.
Thirty-eight children with CP participated in the study. They were recruited from King Khalid Hospital and Physical Therapy Center of College of Applied Medical Sciences at Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia. Their age ranged between 10 and 16 years, were functioning at levels I or II according to the Gross Motor Function Classification System, and had spasticity level 1 or 1+ per the Modified Ashworth Scale. Children were excluded if they had nonreducible structural deformities, received neurolytic agents such as BOTOX or Phenol injections in the past six months, underwent neuromuscular or orthopedic surgery in the last 12 months, or if they had cardiopulmonary problems preventing them from performing high-intense exercise training.
Outcome measures
The plyometric exercise group received a 12-week plyometric training program. Each session lasted 45 minutes and was repeated two times a week. The training was conducted in conformity with the National Strength and Conditioning Association guidelines and American Academy of Pediatrics safety standards. The plyometric exercise program consisted of ten unilateral and bilateral lower limb plyometrics in the form of hopping/bounding/jumping activities. The Iplyometric workout was proceeded by a 5-minute warm-up and ended up with a 5-minute cool-down. The control group received their usual physical rehabilitation program for 45 minutes, twice/week for 12 consecutive weeks. The program comprised advanced balance training, and gait training exercises, postural and flexibility exercises, strength training exercises.
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This study's enrollment of 38 is above the median of 33 across 1,368 interventional studies indexed under Cerebral Palsy.
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Exclusion Criteria:
Participants in this group received the plyometric training program
Other: Plyometric Exercises
Participants in this group received the standard physical rehabilitation program
Other: Standard Physical Therapy
The plyometric exercise group received a 12-week plyometric training program. Each session lasted 45 minutes and was repeated two times a week. The training was conducted in conformity with the National Strength and Conditioning Association guidelines and American Academy of Pediatrics safety standards. The plyometric exercise program consisted of ten unilateral and bilateral lower limb plyometrics in the form of hopping/bounding/jumping activities. The Iplyometric workout was proceeded by a 5-minute warm-up and ended up with a 5-minute cool-down
The control group received their usual physical rehabilitation program for 45 minutes, twice/week for 12 consecutive weeks. The program comprised advanced balance training, and gait training exercises, postural and flexibility exercises, strength training exercises.
Gastrocnemius muscle-tendon length
The distance from the medial femoral epicondyle to the insertion of the Achilles tendon on the calcaneus. The gastrocnemius muscle-tendon length normalized to the lower limb length (%) was recorded.
Time frame: 2 months
Achilles tendon length
The distance from the gastrocnemius muscle-tendon junction to its insertion. The achilles tendon length normalized to the lower limb length (%) was recorded.
Time frame: 2 months
Gastrocnemius muscle belly length
Distance between the medial femoral epicondyle and its muscle-tendon junction. The gastrocnemius muscle belly length normalized to the lower limb length (%) was recorded.
Time frame: 2 months
Fascicle length
The linear distance (mm) between the insertion into the deep and superficial aponeurosis.
Time frame: 2 months
Pennation angle
The angle (in degrees) between the fascicle and the deep aponeurosis.
Time frame: 2 months
Gastrocnemius muscle thickness
The perpendicular distance (mm) between the deep and superficial aponeurosis.
Time frame: 2 months
Passive range of motion of the ankle
The passive ankle dorsi and plantar flexion angle (degrees) were measured by moving the ankle into maximum dorsiflexion and plantarflexion through the isokinetic dynamometry.
Time frame: 2 months
Isometric maximum voluntary contractions of the plantar flexors.
The isometric maximum voluntary contraction was determined as the maximum rate of force (Nm) that participants were able to develop during an isometric contraction of the plantar flexors with the ankle in a neutral position (90 degrees) and the knee in a full extension.
Time frame: 2 months
Achilles tendon elongation
The difference (mm) between the calculated length changes of the muscle-tendon unit and the muscle-length changes recorded by the ultrasound.
Time frame: 2 months
Achilles tendon stiffness
The achilles tendon stiffness (N/m) was calculated through linear regression of the absolute tendon force and related changes in tendon length.
Time frame: 2 months
Achilles tendon strain
The achilles tendon strain (%) was calculated as the tendon elongation divided by the initial tendon length
Time frame: 2 months
Achilles tendon stress
The achilles tendon stress was calculated as the tendon elongation divided by the initial tendon length and expressed in (N/mm2).
Time frame: 2 months
Young's modulus
Young's modulus (N/mm2) was calculated as the ratio of achilles tendon tensile stress to tensile strain
Time frame: 2 months
Plan to share: No
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Cairo University