Comparison Between Schroth and Klapp Method in CP Children With Scoliosis

Summary

Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. Approximately one-third of children with CP are non-ambulant and subsequently spend prolonged periods of time in sitting or lying. Non-ambulatory patients with cerebral palsy (CP) bear a high risk of developing simultaneous progressive scoliotic spine deformities, loss of sitting balance and hip subluxation/dislocation.Treatments for the Spinal deformities associated with cerebral palsy are Schroth method. It is a scoliosis-specific exercise approach that uses postural, scoliosis-specific sensorimotor exercises. While another treatment approach Klapp method aimed to stretch and strengthen muscles by all fours positions, easily applied and that can be used in small groups.

A Randomized clinical trial will be conducted through convenient sampling. Inclusion criteria of this study is age between 8 to 12 years of either gender, with GMFCS level I and II and Trunk rotation angle (ATR) \> 4 degree, who are able to understand and follow verbal instructions. Those patients who has been prescribed brace treatment, has scheduled or undergone any corrective surgical treatment of the spine before or during data collection process will be excluded. Patients who are unable to participate, or are reluctant to receive treatment are excluded. Study will be conducted on 22 patients who will be randomly allocated into two groups. One group will receive Schroth exercises. It consists of passive and active postural auto-correction exercises done repeatedly and based on kinesthetic and sensorimotor principles. While the other group with Klapp method includes stretching and strengthening muscles by all fours positions. Bunnell's scoliometer, Adams forward bend test, and Posture and postural ability scale (PPAS) will be used as outcome measure.

Conditions

• Cerebral Palsy
• Scoliosis

Interventions

OTHER

Schroth Exercises

The patients in the Schroth exercise group will start their exercise program under physiotherapist supervision.Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks.These exercises include spinal elongation, de-rotation, de-flexion, stretching, strengthening exercises to maintain vertebral alignment.The participants will be asked to combine these exercises with their daily living activities (ADLs).During the Schroth exercises, rice bags, foam blocks, a stool, and long sticks will be used to adjust the posture and give passive support.Exercises are progressed from lying, sitting, or standing positions and from most to least passive support per a review of the quality of the performance.Decreasing the amount or degree of passive support, changing the patient's position, and adjusting the sets and repetitions of exercises will depend on the patient's improvement in exercise performance

OTHER

Klapp Exercises

The patients in the Klapp exercise group will be treated with supervised klapp exercises. Exercise treatment program will consist of 18 sessions, 30 minutes each session, three times a week, for 6 weeks.In each session, a sequence of 8 postures of Klapp Exercises will be carried out. Each posture will be maintained for 4-5 minutes with rest breaks when needed.Positions that will be held are: 1) Lateral crawl, 2) Horizontal sliding, 3) Crawl posture near the ground, 4) Bunny hopping, 5) Arm turn, 6) Big arch, 7) Lateral crawl near the ground, 8) Big curve

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Ayesha Khaliq, MS* · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

8 Years

Max Age

12 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-05-14

Primary Completion

2024-07-21

Completion

2024-07-28

Countries

• Pakistan

Study Locations