Cerebral Palsy (CP), Unilateral Cerebral Palsy
Conditions
Brief summary
PURPOSE: The purpose of this randomized controlled trial was to investigate the potential carry-over effects of a 6-week lower limb strengthening-based cross-training (CT) priming protocol, added to standard physical rehabilitation, on affected upper limb function in children aged 6-8 years with unilateral cerebral palsy (UCP), compared to standard physical rehabilitation alone. BACKGROUND: Children with unilateral cerebral palsy (UCP) experience motor impairments affecting both lower and upper limbs, significantly impacting functional independence. While rehabilitation often targets specific limbs, interventions may induce broader neuroplastic changes. Movement-based priming, particularly strengthening-based cross-training (CT) targeting the less-affected limb, has shown promise for improving contralateral lower limb function in UCP, likely via cross-education mechanisms involving central nervous system adaptations. However, it remains largely unexplored whether such lower limb-focused priming interventions can induce secondary "carry-over" effects, positively influencing the function of the ipsilaterally affected upper limb through potential mechanisms like widespread neural adaptations or improved postural stability. Addressing this gap is crucial for understanding the holistic impact of priming interventions and optimizing rehabilitation strategies. HYPOTHESES: There will be no statistically significant difference in the improvement of affected handgrip strength, grasping skills and functional UL Outcome Measure between children receiving lower limb CT priming plus standard rehabilitation and those receiving standard rehabilitation alone over the 6-week intervention period. RESEARCH QUESTION: Does the addition of a 6-week lower limb strengthening-based cross-training priming protocol to standard physical rehabilitation result in significantly greater improvements in affected upper limb function (specifically handgrip strength and grasping skills) compared to standard physical rehabilitation alone in children aged 6-8 years with unilateral cerebral palsy?
Interventions
60-minute physical therapy program including strengthening, balance, and functional activities for children with unilateral cerebral palsy.
OTHERLower Limb Cross-Training Priming
10-15 minutes of lower limb strengthening-based cross-training of the less-affected limb used as movement-based priming prior to standard rehabilitation.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
6 Years to 8 Years
Healthy volunteers
No
Inclusion criteria
* Mild spasticity (MAS 1 or 1+), independent ambulation (AFOs permitted), and the ability to follow simple instructions.
Exclusion criteria
* Children with significant fixed deformities, cognitive or sensory impairments hindering participation, uncontrolled epilepsy, or recent interventions like botulinum toxin or orthopedic surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Handgrip Strength (HGS) | Baseline and after 6 weeks of training | Handgrip strength measured by Jamar hand dynamometer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peabody Developmental Motor Scales-2, Fine Motor subtest (PDMS-2 FM) - Grasping Age Equivalent | Baseline and after 6 weeks of training | Grasping age equivalent measured by Peabody Developmental Motor Scales-2, Fine Motor subtest (PDMS-2 FM) |
Countries
Egypt
Outcome results
None listed