An interventional study of Progressive Hop-Stabilization Training and Traditional physical therapy in Burn Injury, Postural Balance Disorders and Gait Impairment, sponsored by Qassim University. Completed at 1 site in Saudi Arabia. Open to participants aged 10 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-10-26.
Sponsored by Qassim University · Not applicable, Interventional, and Treatment
Children with severe burns affecting both lower limbs may experience persistent difficulties with balance, walking, and physical function. This randomized controlled trial investigated whether adding progressive hop-stabilization training to standard physical rehabilitation improves postural control, dynamic balance, gait, and lower-limb function.
Fifty-four children aged 10-17 years with healed bilateral lower-limb burns were randomly assigned to two groups. Both groups received standard rehabilitation three times weekly for eight weeks, while the experimental group additionally performed supervised hop-stabilization exercises. Postural stability, dynamic balance, walking ability, and lower-limb functional performance were assessed before and immediately after treatment.
Children with lower-limb burns may experience persistent limitations in balance, gait, and lower-limb function. Hop-stabilization training provides repeated multidirectional loading, controlled landing, and rapid postural adjustment and may therefore represent a task-specific rehabilitation strategy; however, its effects in pediatric burn rehabilitation remain unclear. This two-arm, parallel-group randomized controlled trial will include 54 children aged 10-17 years with healed bilateral lower-limb burns and total body surface area involvement >30%. Participants will be randomly allocated in a 1:1 ratio to either a hop-stabilization group receiving progressive hop-stabilization training in addition to traditional physical therapy or a control group receiving traditional physical therapy alone. Both groups will receive treatment three times weekly for 8 weeks. The experimental program will include progressive multidirectional hopping and landing-stabilization exercises. Outcomes will be assessed at baseline and after treatment by a blinded examiner.
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Participants received an eight-week progressive hop-stabilization training program in addition to standard physical rehabilitation. Training was supervised by a physiotherapist and conducted three times weekly.
Other: Progressive Hop-Stabilization Training · Other: Traditional physical therapy
Participants underwent supervised standard physical rehabilitation three times weekly for eight weeks.
Other: Traditional physical therapy
In addition to traditional physical therapy, participants in the experimental group received a progressive hop-stabilization training program three times per week for eight consecutive weeks. The program included side-to-side hopping, forward-and-backward hopping, forward hop-and-stabilization, figure-8 hopping, zigzag hopping, and 4-square hopping. All exercises were performed under the direct supervision of a physiotherapist. Difficulty throughout the program was progressively, verbal feedback was provided throughout the hop-stabilization program to promote appropriate landing biomechanics.
Participants in both groups received a supervised traditional rehabilitative exercise program three times per week for eight consecutive weeks. The program was individualized according to each child's functional status, burn characteristics, and exercise tolerance. Each 50-60-minute session included warm-up, aerobic conditioning, progressive strengthening, functional training, scar management as indicated, and cool-down.
Postural Stability
Postural stability and dynamic Limits of Stability (LOS) were assessed using the ProKin System. Across three maximum-effort trials with 60-second rest intervals, the software calculated: Mediolateral Excursion Limit (%), Anteroposterior Excursion Limit (%), Overall Excursion Area (mm2), Directional Control Index, and Trunk Displacement Angle (o), with the mean of three successful trials retained for statistical analysis.
Time frame: Baseline (Pre-Intervention)
Postural Stability
Postural stability and dynamic Limits of Stability (LOS) were assessed using the ProKin System. Across three maximum-effort trials with 60-second rest intervals, the software calculated: Mediolateral Excursion Limit (%), Anteroposterior Excursion Limit (%), Overall Excursion Area (mm2), Directional Control Index, and Trunk Displacement Angle (o), with the mean of three successful trials retained for statistical analysis.
Time frame: Week 8 (Post-Intervention)
Lower Quarter Y-Balance Test (YBT-LQ)
Dynamic balance was assessed using the Lower Quarter Y-Balance Test (YBT-LQ). Participants stood on one leg on the central platform and reached as far as possible with the contralateral leg in the anterior (AT), posteromedial (PM), and posterolateral (PL) directions while maintaining balance. The composite score for was calculated as: composite score (%) = \[AT + PM + PL maximal reach distances (cm)\] / \[3 × lower-limb length (cm)\] × 100.
Time frame: Baseline (Pre-Intervention)
Lower Quarter Y-Balance Test (YBT-LQ)
Dynamic balance was assessed using the Lower Quarter Y-Balance Test (YBT-LQ). Participants stood on one leg on the central platform and reached as far as possible with the contralateral leg in the anterior (AT), posteromedial (PM), and posterolateral (PL) directions while maintaining balance. The composite score for was calculated as: composite score (%) = \[AT + PM + PL maximal reach distances (cm)\] / \[3 × lower-limb length (cm)\] × 100.
Time frame: Week 8 (Post-Intervention)
Functional Gait Assessment Modified for Children
Functional gait performance was assessed using the Functional Gait Assessment modified for Children (FGA-mC). The FGA-mC consists of 10-item assessment designed to evaluate higher-level gait performance under progressively challenging conditions. Higher scores indicate better functional gait performance.
Time frame: Baseline (Pre-Intervention)
Functional Gait Assessment Modified for Children
Functional gait performance was assessed using the Functional Gait Assessment modified for Children (FGA-mC). The FGA-mC consists of 10-item assessment designed to evaluate higher-level gait performance under progressively challenging conditions. Higher scores indicate better functional gait performance.
Time frame: Week 8 (Post-Intervention)
Single Hop for Distance Test
The Single Hop for Distance Test used to assess unilateral lower-limb functional performance, including forward propulsion and landing control. Hop distance was measured to the nearest 0.5 cm from the starting line to the posterior aspect of the heel at landing. To allow standardized comparisons, absolute hop distance (cm) was normalized to leg length and demonstrated as a percentage.
Time frame: Baseline (Pre-Intervention)
Single Hop for Distance Test
The Single Hop for Distance Test used to assess unilateral lower-limb functional performance, including forward propulsion and landing control. Hop distance was measured to the nearest 0.5 cm from the starting line to the posterior aspect of the heel at landing. To allow standardized comparisons, absolute hop distance (cm) was normalized to leg length and demonstrated as a percentage.
Time frame: Week 8 (Post-Intervention)
Timed Up and Down Stairs Test
Timed Up and Down Stairs Test was used to assess functional mobility. the subject was asked to stand 30 cm from the bottom of a 14-step flight of stairs (19.5-cm step height). The test score was the time in seconds from the "go" cue until the second foot returned to the bottom land
Time frame: Baseline (Pre-Intervention)
Timed Up and Down Stairs Test
Timed Up and Down Stairs Test was used to assess functional mobility. the subject was asked to stand 30 cm from the bottom of a 14-step flight of stairs (19.5-cm step height). The test score was the time in seconds from the "go" cue until the second foot returned to the bottom land
Time frame: Week 8 (Post-Intervention)
Timed One-Legged Stance Test
The Timed One-Legged Stance test was used to assess single-limb static balance and postural control. Timing began when the no stance foot left the floor and stopped if the participant removed the hands from the hips, looked down, touched the floor with the contralateral foot, or otherwise lost the test position. Performance was recorded in seconds, with longer times indicating better balance ability.
Time frame: Baseline (Pre-Intervention)
Timed One-Legged Stance Test
The Timed One-Legged Stance test was used to assess single-limb static balance and postural control. Timing began when the no stance foot left the floor and stopped if the participant removed the hands from the hips, looked down, touched the floor with the contralateral foot, or otherwise lost the test position. Performance was recorded in seconds, with longer times indicating better balance ability.
Time frame: Week 8 (Post-Intervention)
Plan to share: No
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Qassim University