Achilles Tendon Contracture, Cerebral Palsy, Spastic
Conditions
Keywords
Myofascial Release, Physical Therapy, Pediatric Rehabilitation, Gross Motor Function, Range of Motion, Gaza Strip
Brief summary
"This study aims to evaluate the effectiveness of adding Myofascial Release (MFR) technique to a conventional physiotherapy program for children with cerebral palsy after Achilles tendon surgery. The primary goal is to determine whether MFR can improve functional outcomes such as gross motor function and ankle range of motion, compared to physiotherapy alone. The study will be conducted in Gaza, Palestine, with children diagnosed with cerebral palsy who recently underwent Achilles tendon surgery. Participants will be randomly assigned to either conventional physiotherapy or conventional physiotherapy combined with MFR, and outcomes will be assessed before and after an 8-week intervention program."
Detailed description
"Children with cerebral palsy (CP) often develop musculoskeletal complications, including Achilles tendon contractures, which may require surgical intervention. Despite surgery, many children continue to experience limitations in functional mobility and reduced range of motion. Conventional physiotherapy programs are commonly provided postoperatively to enhance recovery; however, additional manual therapy techniques such as Myofascial Release (MFR) may further improve outcomes. This randomized controlled trial investigates the effectiveness of adding MFR to conventional physiotherapy for children with CP after Achilles tendon surgery in Gaza. Participants will be randomly allocated to either a control group (conventional physiotherapy only) or an intervention group (conventional physiotherapy plus MFR). Functional outcomes, including gross motor function (GMFM-88) and ankle range of motion, will be measured pre- and post-intervention. It is hypothesized that children receiving MFR in addition to conventional physiotherapy will demonstrate greater improvements in functional mobility and ankle range of motion compared to those receiving physiotherapy alone."
Interventions
OTHERConventional Physiotherapy
A standard physiotherapy program provided after Achilles tendon surgery, including stretching, strengthening, mobility, and functional training exercises
OTHERMyofascial Release Technique
A manual therapy technique applied to the lower limb and ankle region, aiming to release fascial restrictions, improve soft tissue flexibility, and enhance ankle range of motion.
Sponsors
Ismail K. Al-Qudra
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
"Participants will be randomly assigned to one of two parallel groups: conventional physiotherapy only or conventional physiotherapy plus myofascial release."
Eligibility
Sex/Gender
ALL
Age
2 Years to 5 Years
Healthy volunteers
No
Inclusion criteria
* Children aged 2-5 years * Spastic cerebral palsy diagnosis (GMFCS levels I-IV). * Underwent Achilles tendon surgery within the past 3 months * Medically stable and cleared to begin physiotherapy. * Parental/guardian consent to participate in the study.
Exclusion criteria
* Other neuromuscular disorders * Severe cognitive impairments that hinder participation * Previous MFR therapy within the last 6 months * Participation in another rehabilitation study in the past 3 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gross Motor Function Measure (GMFM-88) | Baseline and after 8 weeks of intervention] | Change in gross motor function measured using the GMFM-88 scale. The scale assesses motor function in children with cerebral palsy across five dimensions: lying \& rolling, sitting, crawling \& kneeling, standing, and walking/running/jumping. Scores range from 0 to 264, with higher scores indicating better motor function. |
| Ankle Range of Motion (ROM) | Baseline and after 8 weeks of intervention | Passive ankle dorsiflexion range of motion measured using a goniometer. Improved ROM indicates increased flexibility and joint mobility. |
| Pediatric Balance Scale (PBS) | Baseline and after 8 weeks of intervention | Change in balance performance measured using the Pediatric Balance Scale (PBS), which consists of 14 functional balance tasks. The minimum possible score is 0 and the maximum possible score is 56, with higher scores indicating better balance ability. |
Countries
Palestinian Territories
Contacts
PRINCIPAL_INVESTIGATORIsmail K Al Qedra, MSc (Physiotherapy)
Al-Azhar University - Gaza
STUDY_DIRECTORMusab M Al Dabbas, PhD
Al-Azhar University - Gaza
Outcome results
None listed