Rhythmic Stabilization Versus Ball Balancing

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age6-12
SponsorRiphah International University

About this trial

Spastic Cerebral Palsy (CP) is the leading cause of upper motor neuron syndrome (UMN) in children. The primary factors contributing to motor behavior disorders in these children are impairments in motor control and muscle strength. These impairments result in changes in muscle growth and hinder the development of motor skills, leading to reduced muscle force generation and decreased flexibility. Spastic cerebral palsy is the most prevalent type, affecting 77% of individuals with CP, and is caused by damage to the motor cortex and pyramidal tracts. The motor cortex is responsible for transmitting voluntary movement signals from the brain to the muscles. Characteristics of spastic cerebral palsy include stiff muscles (hypertonia), which can cause jerky and repetitive limb movements (spasticity). Additionally, individuals with CP often have difficulties in processing somatosensory and proprioceptive information. Proprioceptive training refers to interventions aimed at enhancing proprioceptive function to ultimately improve motor performance, a concept that has been explored in studies focused on sports injuries. In this study, we will utilize two proprioceptive exercises-rhythmic stabilization and ball balancing-to promote functional improvement in the upper extremities of children with spastic CP.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Spastic diplegic CP children age 6 to 12 years,

Each gender included

Grade 1 of spasticity according to modified Ashworth scale (21)

With normal I.Q. greater than 70 (assessed by psychologist),

Disqualifiers

Children with any other neurological impairment

Children with audio visual impairment

Trial design

Design model

Parallel

Treatments tested in this trial

  • Rhythmic Stabilization

    Other intervention

    Rhythmic Stabilization Program for Children with Cerebral Palsy Objective: Enhance upper extremity strength and stability through rhythmic stabilization exercises. Program Overview: Duration: 30-minute sessions Frequency: Once per week for 6 weeks Exercise Steps: Positioning: The child positions their upper extremity within their available range of motion. Isometric Contraction: The child holds an isometric contraction, maintaining the position without movement. Therapist's Role: Apply resistance that is sufficient to elicit a reaction but not enough to disrupt the isometric contraction. Progression: Gradually increase the duration of the isometric hold. Increase the amount of resistance applied. Decrease the contact area between the therapist's hands and the child's upper extremity to enhance stability challenges. Monitoring and Adjustments: Assess the child's ability to maintain the contraction and adapt the resistance and support as needed. Encourage the child's engagement.

  • Ball Balancing

    Other intervention

    Ball Balancing Program Objective: Improve balance and stability. Equipment: 48-inch gymnastic ball Program Details: * Duration: 6 weeks * Frequency: As needed Steps: 1. Initial Balance: * Eyes Open: Balance on hands for 10 seconds. * Progression: Increase to 3-5 repetitions of 60 seconds. 2. Eyes Closed: Repeat the above exercise with eyes closed. 3. Variations: * Both Hands on One Ball * Each Hand on Separate Balls * Weaker Arm on One Ball 4. Body Positions: Progress through four body positions with eyes open, then closed. 5. Correction: If the child misses a position, they open their eyes and reposition actively.

Treatment groups

36 Participants
are divided into 2 treatment groups
Group A: Rhythmic Stabilization groupExperimental treatment 1 intervention
Group B: Ball Balancing groupExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

QUEST ( Quality of Upper Extremity Skills Test)

The Quality of Upper Extremity Skills Test (QUEST) is a reliable and valid tool that assesses hand function and movement patterns in children with cerebral palsy. It can be used with children aged 6 to 12 years (23). The test is conducted in a play environment and consists of 34 activity items. The test assesses four domains: Dissociated movements, Grasp, Protective extension. Reliability is 0.96 and validity is 0.84.

Time frame
6 weeks
2

SHUEE Scale

The Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) is a video-based tool for the assessment of upper extremity function in children with hemiplegic cerebral palsy. This tool includes spontaneous functional analysis and Effects of Rhythmic Stabilization versus Ball Balancing on Spastic CP 3dynamic positional analysis and assesses the ability to perform grasp and release. The validity is 0.47 and reliability is 0.99

Time frame
6 weeks

Secondary outcomes

Other outcomes

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