A. Patients preparation All the children demographic and outcome measures data will be collected in specially well-designed sheets1. Evaluation of fine motor skills using PDMS-2 Evaluation of hand function using Besta scale
. The traditional exercise program (given to both groups):
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Treatment protocol in Group A, Reciprocal electrical stimulation protocol
- The device has two channels that can stimulate two opposing groups of muscles alternatively (reciprocate).
- During ES, the child sits in a chair with his treated forearm resting on a pillow placed on the bed in front of him.
- The electrodes will be placed as follows:
- Channel 1 (stimulates wrist and hand extensors) electrodes placed over the dorsum of the forearm as follows: the active electrode is placed over the common extensor origin, while in different over the motor point of extensor pollicis longus, abductor pollicis longus, and extensor indices.
- Channel 2 (stimulates wrist and hand flexors) electrodes placed on the palmar side of the forearm are as follows: the negative electrode is placed between the finger flexors and wrist flexors. The positive electrode is placed over the tendonportion of the forearm,
- The treatment duration will be 20 minutes.
- The treatment protocol will be repeated 3 times per week for 12 weeks.
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Treatment protocol in Group B, Kinesio taping protocol:
- Kinesio taping will be applied on both sides of the upper limb.
- The applied area will be from the proximal one-third of the forearm to the wrist and then will be split into 5 straps into the distal interphalangeal joint of fingers.
- On the dorsal side, KT will be applied on the forearm, wrist, and fingers extensors for improvement of wrist and fingers extension.
- On the plantar side, KT will be applied on the forearm, wrist, and fingers flexors for inhibition of wrist and fingers flexion.
- Taping will be applied for 6 days, 24 h a day, on the affected upper limb, and it will be removed for only one day per week.