Effect of Callisthenic Training on Mobility and ADL Performance in Spastic Diplegic Cerebral Palsy Patients

Summary

Almost 2 to 3 out of every 1000 children have Cerebral palsy in Pakistan.Spastic type of CP is dominant about 75%, diplegia (40%) and hemiplegic are (35.5%).Spastic diplegics have tightness of lower limb more than upper limb.Their chief complaints are reduced mobility,impaired balance and coordination and lack of postural control and stability.Calisthenic training is sort of strengthening exercises in which patient use his/her own body weight as a resistance.

Calisthenic training aims to reduce movement limitation,contracture formation and improves patient's mobility for daily transfers and ambulation,active participation of patient in indoor and outdoor activities and enhance postural stability and controle during routine tasks. The current study aims to determine the effects of calisthenic training on mobility and ADL performance in spastic diplegic cerebral palsy children aged 5-12 years fulfilling the GMFCS criteria levels 1-3. A randomized control trial will be conducted in multidisciplinary lab of FUCP, department of physical medicine and peads and rehabilitation of Fauji Foundation Hospital on the sample of 32 participants. The subjects will be randomized into two groups by sealed opaque envelope method. Baseline assessment would be done by using WEEFIM measurement assessment scale for mobility and ADL performance, pediatric balance assessment Scale for postural control. Data will be collected at baseline before intervention, after 3 weeks and finally after 6 weeks of intervention. Interventional group will be receiving calisthenic training and conventional physical therapy while control group will be receiving conventional physical therapy alone. Exercise training would be done for a total of 12 sessions for 6 weeks, twice a week with each session lasting 45 minutes. Analysis would be done by using SPSS version 21. Ethical approval will be obtained from ERC of FUSH. Informed written consent will be obtained from all participants.

Conditions

• Activities of Daily Living
• Postural Control
• Spasticity
• Mobility

Interventions

PROCEDURE

calisthenic training

COMMAND AND TARGET MUSCLE GROUP 1. LEG RAISES (LEG STRENGTH) LIE ON YOUR BACK WITH YOUR LEGS STRAIGHT. LIFT LEGS OFF THE GROUND IN FRONT. LOWER THEM BACK DOWN WITHOUT TOUCHING THE FLOOR. TARGETS HIP FLEXOR 2. SIDE LEG RAISES (LEG STRENGTH) LIE ON YOUR BACK WITH YOUR LEGS STRAIGHT. LIFT LEGS OFF THE GROUND AND TAKE IT TO SIDE MAXIMALL WITHOUT TOUCHING THE FLOOR. TARGETS LOWER ABS AND HIP ABDUCTORS 3. GLUTE BRIDGES ( BACK STRENGTH) LIE ON YOUR BACK WITH YOUR KNEES BENT. LIFT YOUR HIPS OFF THE GROUND, SQUEEZING YOUR GLUTES. LOWER AND REPEAT. TARGETS GLUTES AND HAMSTRINGS. 4. QUADRUPTED POSITION: ASK THE PATIENT TO RIDE YOUR KNEES PLAY 'HORSY' AND SLOWLY MOVE YOUR KNEES TO AND FRO AND SIDEWAYS SO THAT TO SHIFT WEIGHT FROM SIDE TO SIDE. 5. WALL LEG LIFTS IN STANDING STAND WITH YOUR SIDE FACING A WALL. LIFT YOUR LEG OUT TO THE SIDE AS HIGH AS POSSIBLE. LOWER AND REPEAT WITH THE OTHER LEG. TARGETS HIP ABDUCTERS 6. KNEELING 7. VERTICLE LIFT 8. Squats

PROCEDURE

Conventional physical therapy group

CONVENTIONAL PHYSICAL THERAPY CONVENTIONAL PHYSICAL THERAPY Week 1 Orientation of exercises Week 2-3 UPPER LIMB (20 MINS) Lifting a glass of water with elbow extended Moving objects from the table to a box Combing Hairs LOWER LIMB (20 MINS) Lifting the lower extremity and lowering in o nto a footstool sit to stand Standing up with loaded trey in hand corner hamstring stretch butterfly stretch Week 4-5 UPPER LIMB (20 MINS) Grasping and releasing objects lifting a glass of water to a level of 90° shoul der flexion with an extended elbow Moving objects from the table to a box LOWER LIMB (20 MINS) Reciprocal leg flexion and extension single leg stance Kicking a ball Week 5-8 UPPER LIMB (20 MINS) Opening Jars Throwing Balls Same As previous weeks LOWER LIMB (20 MINS) Squatting

Sponsors & Collaborators

• Foundation University Islamabad

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

5 Years

Max Age

13 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-09-12

Primary Completion

2025-05-02

Completion

2025-05-02

Countries

• Pakistan

Study Locations