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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.
OBJECTIVES OF STUDY
HYPOTHESIS:
Alternate hypothesis:
NULL HYPOTHESIS
1H0 -There will be no statistically significant difference in the effect of calisthenic training in comparison to conventional physical therapy to improve ADL performance in spastic diplegic cp patients (p<0.05).
2H0 -There will be no statistically significant difference in the effect of calisthenic training in comparison to conventional physical therapy to improve mobility in spastic diplegic cp patients (p<0.05).
3H0 -There will be no statistically significant difference in the effect of calisthenic trainingin comparison to conventional physical therapy to improve postural controle in spastic diplegic cp patients (p<0.05).
Significanve of study:
As there is no any Conclusive evidence of calisthenic training more precisely for spastic diplegic cp children so this study will be helpful for patients and other health care proffessionals to implement this study in their clinical practice and for the patients in a way they can keep continue this treatment protocol in their home bound friendly environment by using their own body weights as a resistance after quiting from sessions of this research .
it will provide a treatment protocol for targeting calisthenic training to improve mobility, incorporate postural corrections and functional capacitance in spastic cp children .
This study will maximize the indoor functional independency in the cerebral palsy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| calisthenic training group | Experimental | CALISTHENIC TRAINING CALISTHENIC EXERCISES COMMAND AND TARGET MUSCLE GROUP
|
|
| conventional physical therapy group | Experimental | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| calisthenic training | Procedure | COMMAND AND TARGET MUSCLE GROUP
|
| Measure | Description | Time Frame |
|---|---|---|
| mobility | The WeeFIM was used, it is an 18-item, 7-level ordinal scale. Each item is scored on a 7-level scale, with the total score ranging from 18 (lowest) to 126 (highest). | 8 weeks |
| Activities of Daily Living Performance | Will be measured by weefim functional independence measure scale. It is an 18-item, 7-level ordinal scale. Each item is scored on a 7-level scale, with the total score ranging from 18 (lowest) to 126 (highest). | 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Postural control | Will be assessed by paediatric assessment scale It has 14 items and 5 level scale.1 indicating complete dependence and 5 indicating complete independence total score are 56. | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Foundation University College of Physical Thrapy | Islamabad | 44000 | Pakistan |
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|
| Conventional physical therapy group | Procedure | 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 |
|
| ID | Term |
|---|---|
| D009128 | Muscle Spasticity |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009122 | Muscle Hypertonia |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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