The Role of Pilates, Plyometrics, and Their Combination for Children With Unilateral Cerebral Palsy

Cairo University (CU)

Status: Completed

Conditions: Cerebral Palsy

Treatments: Other: Plyometric-based Muscle Loading Exercises; Other: Pilates-based Core Strengthening Exercises; Other: Combined Pilates and Plyometrics

Study type: Interventional

Funder types: Other

Identifiers

NCT05429281

RHPT/0021/0114

Details and patient eligibility

About

This study was conducted to compare the effect of Pilates-based core strengthening (PsCS) and plyometric-based muscle loading (PlyoML) and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP were randomly allocated to the PsCS (n = 27), PlyoML (n = 27), or combined intervention (n = 27) group. Participants in the three groups were assessed for postural control, balance, and mobility on the pre and post-treatment occasions.

Full description

Eighty-one children with ULCP were recruited from the Physical Therapy Outpatient Clinic of College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, King Khalid Hospital, and a tertiary referral hospital, Al-Kharj, Saudi Arabia. Their age ranged between 12 and 18 years, were functioning at levels I or II according to the Gross Motor Function Classification System, and had spasticity levels 1 or 1+ per the Modified Ashworth Scale. Children were excluded if they had fixed deformities, underwent neuromuscular or orthopedic surgery in the last 12 months, submitted to BOTOX injection in the past 6 months, had attentional neglect, and if they had cardiopulmonary problems preventing them from performing high-intense exercise training.

Outcome measures

• Postural control: The directional dynamic limit of stability (forward, backward, paretic, and non-paretic) and overall limit of stability were assessed using the Biodex balance system.
• Balance and mobility: The Community Balance and Mobility Scale (CB&M), Functional Walking Test (FWT), and Timed Up and Down Stair test (TUDS) were used to quantify balance and mobility capacity.

Interventions

All groups were trained for 45 minutes, twice per week, for 12 successive weeks. The PsCS group performed eight Pilates exercises geared predominantly toward the core muscles. The PlyoML group performed 10 plyometric exercises primarily focused predominantly on the lower body. The combined group combined the same exercises as the PsCS and PlyoML groups, although with half the number of sets/repetitions.

Enrollment: 81 patients

Sex: All

Ages: 12 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Unilateral cerebral palsy
• Age 12-18 years
• Motor function level I or II according to the Gross Motor Function Classification System.
• Spasticity level 1 or 1+ according to the Modified Ashworth Scale

Exclusion criteria

• Structural deformities/contractures
• Musculoskeletal or neural surgery in the last year
• BOTOX injection in the last 6 months.
• Cardiopulmonary disorders interfere with the ability to engage in exercise training.
• Perceptual and/or behavioral disorders.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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81 participants in 3 patient groups

Pilates-based Core Strengthening Group

Active Comparator group

Description:

Participants in this group performed eight PsCS exercises geared predominantly to the core muscles.

Treatment:

Other: Pilates-based Core Strengthening Exercises

Plyometric-based Muscle Loading Group

Active Comparator group

Description:

Participants in this group performed 10 PlyoML exercises primarily focused on the lower body.

Treatment:

Other: Plyometric-based Muscle Loading Exercises

Combined training group

Experimental group

Description:

Participants in this group performed the same exercises as the PsCS and PlyoML groups, although with half the number of sets/repetitions.

Treatment:

Other: Combined Pilates and Plyometrics