Upper Extremity Strengthening Interventions in Children With UCP (PNF vs PLY-UCP)

Biruni University

Status: Enrolling

Conditions: Cerebral Palsy (CP)

Treatments: Other: Exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT07116798

FTR-UCP-001

Details and patient eligibility

About

This study aims to compare the effects of two different upper extremity strengthening exercise approaches-bilateral strengthening exercises based on Proprioceptive Neuromuscular Facilitation (PNF) patterns and plyometric exercises-on muscle thickness, joint range of motion, muscle strength, and functional performance in children with unilateral spastic cerebral palsy (USCP). Although strengthening exercises targeting the affected upper limb in children with USCP have been investigated in numerous studies, to our knowledge, no previous research has directly compared the effects of bilateral PNF-based strengthening exercises and plyometric training. Incorporating PNF patterns into upper extremity rehabilitation programs has been previously recommended, and examining the efficacy of these exercises in comparison with plyometric training may contribute valuable insights to the literature and inform clinical practice.

Enrollment: 14 estimated patients

Sex: All

Ages: 5 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged between 5 and 12 years
• Diagnosed with unilateral spastic type cerebral palsy
• Classified as Level I or II according to the Gross Motor Function Classification System (GMFCS)
• Classified as Level I or II according to the Manual Ability Classification System (MACS)
• Upper extremity muscle tone ≤2 on the Modified Ashworth Scale
• Willing to suspend other upper extremity therapeutic interventions during the study period
• Able to cooperate and follow instructions provided by the researcher
• Voluntarily willing to participate in the study

Exclusion criteria

• History of any upper extremity surgery or Botulinum toxin (Btx) injection within the past 6 months
• Presence of an additional neurological disorder other than cerebral palsy
• Having visual and/or hearing impairments
• Having severe contractures that limit participation in functional activities

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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14 participants in 2 patient groups

PNF Group (Strengthening Based on Proprioceptive Neuromuscular Facilitation Patterns)

Experimental group

Description:

The shoulder and scapular patterns listed below will first be taught to the child using the rhythmic initiation technique. Following instruction, the child will be asked to perform the patterns actively without resistance. Shoulder flexion - adduction - external rotation and shoulder extension - abduction - internal rotation (with the elbow extended) Shoulder extension - adduction - internal rotation and shoulder flexion - abduction - external rotation (with the elbow extended) In addition to the shoulder patterns, scapular patterns including anterior depression - posterior elevation and anterior elevation - posterior depression will also be performed with the same progression.

Treatment:

Other: Exercise

Other: Exercise

Plyometric Group (Plyometric Exercises)

Experimental group

Description:

Participants in the plyometric group will perform upper extremity plyometric exercises aimed at improving muscular power, neuromuscular control, and functional performance. The exercises will be selected to provide dynamic resistance and emphasize rapid stretch-shortening cycle movements of the upper limb. Training will be conducted using elastic bands, medicine balls, and body weight as appropriate to the child's developmental level and physical capacity. The exercise program will include progressive variations in terms of intensity, volume (sets and repetitions), and complexity over the intervention period, as detailed in the progression table. Rest intervals of no more than one minute will be allowed between sets. All exercises will be performed bilaterally and under the supervision of a physiotherapist to ensure proper technique and safety.

Treatment:

Other: Exercise

Other: Exercise