The primary objective of this study is to assess the effectiveness of battle rope training in improving ROM, reducing pain, and enhancing overall elbow function in children with post-traumatic elbow contracture. By comparing standard therapy alone to standard therapy plus battle rope training, the study aims to determine if this added intervention leads to greater improvements in functional mobility and pain relief.In this randomized controlled trial, participants will be divided into two groups: a control group, receiving standard treatment (ROM exercises, stretching, and heat therapy), and an intervention group, receiving the same standard treatment plus battle rope training. ROM exercises and stretching will focus on gentle elbow flexion and extension to enhance flexibility, while heat therapy will prepare muscles for movement.
The intervention group will additionally perform 10-15 minutes of battle rope training, involving dynamic movements that engage the upper body and increase joint activation. Pre- and post-intervention assessments using a goniometer for ROM, the Flynn scoring system for functional and cosmetic outcomes, and the Visual Analogue Scale (VAS) for pain will provide comprehensive data on the effectiveness of the intervention
Age 8 to 15
Children Suffering from Post-Traumatic Elbow Contracture
Written informed consent obtained from the parents or guardians
Participants must report a pain level of at least 3 on a visual analog scale (VAS)
Post Traumatic Contracture other than Elbow region
Known allergies to materials used in battle rope training.
Children who are unable to commit to the training schedule or follow-up assessments.
Use of medications that may affect pain perception or muscle function, such as opioids or muscle relaxants.
Parallel
Battle Rope Training
Other interventionAll five exercises will be performed 5 days a week with 2 sets.A 12.8-m TR (4.1 kg) was used for all trials Week 1 to 2: During the period the subjects performed 5 selected battle rope exercises. Each exercises the subjects performed ten seconds with two repetitions. The total number of set was 2. The recovery for in between exercise 1minute and in between set was 5 minutes. Week 3 to 4: During the period the subjects performed 5 selected battle rope exercises. Each exercises the subjects performed twenty seconds with 3 repetitions. The total number of set was 2. The recovery for in between exercise 1minute and in between set was 5 minutes. Week 5 to 6: During the period the subjects performed 5 selected battle rope exercises. Each exercises the subjects performed thirty seconds with 4 repetitions. The total number of set was 2. The recovery for in between exercise 1minute and in between set was 5 minutes
Stretching and Heat Therapy
Other interventionThe control group will receive Range of Motion (ROM) exercises, stretching, and heat therapy to manage post-traumatic elbow contracture. ROM Exercises will focus on gentle flexion and extension movements to gradually improve joint mobility . These exercises will be performed daily.Stretching exercises will target the muscles surrounding the elbow specifically designed to lengthen and relax the soft tissues that may contribute to contracture. These stretches will be held for 15-30 seconds and repeated several times per session to facilitate flexibility without overstressing the joint. Heat Therapy will be applied to the affected area . Heat will be applied for approximately 10-15 minutes. This combined approach aims to provide standard care that helps alleviate stiffness, manage pain, and improve functional movement over time, without the addition of the battle rope intervention
Visual Analogue Scale
The Visual Analogue Scale (VAS) is used to measure pain intensity in children with post-traumatic elbow contracture (17). A 10 cm line is provided, with 0 cm indicating "no pain" and 10 cm representing the "worst pain imaginable." Children are asked to mark their current pain level on this line. The distance from the "no pain" end to the mark (measured in cm) is recorded as their pain score (0-10). Scoring Interpretation: * 0 cm: No pain * 1-3 cm: Mild pain * 4-6 cm: Moderate pain * 7-10 cm: Severe pain VAS scores are collected before and after each intervention to track changes in pain. Lower scores over time would suggest effective pain relief from the battle rope training.
ROM using Goniometer
The goniometer is a precise instrument used to measure joint angles and assess the range of motion (ROM) of the elbow(17).It will provide quantifiable data on elbow flexion and extension angles before, during, and after the intervention with battle rope training. Elbow contracture limits joint movement, so any increase in ROM captured by the goniometer can indicate a positive outcome from the intervention. For each measurement, the goniometer will be placed along the lateral aspect of the elbow, with one arm aligned along the humerus and the other along the forearm. The degree of extension and flexion will be measured in a standard position to ensure consistency across multiple sessions. The goniometer offers objective, reproducible data that will help gauge the effectiveness of battle rope training in improving joint flexibility and reducing the severity of contracture. Changes in ROM captured across the study period will be key indicators of functional improvements.
Flynn Scoring
The Flynn scoring system is used to assess the functional and cosmetic outcomes in pediatric elbow injuries, providing a comprehensive score based on a range of clinical factors. Flynn scoring will be applied to evaluate improvements in elbow function following battle rope training for children with post-traumatic elbow contracture.
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