Upper Extremity Strengthening Interventions in Children With UCP

Investigation of the Effects of Different Upper Extremity Strengthening Exercises in Children With Unilateral Spastic Type Cerebral Palsy

This study aims to compare the effects of two different upper extremity strengthening exercise approaches-bilateral strengthening exercises based on Proprioceptive Neuromuscular Facilitation (PNF) patterns and plyometric exercises-on muscle thickness, joint range of motion, muscle strength, and functional performance in children with unilateral spastic cerebral palsy (USCP). Although strengthening exercises targeting the affected upper limb in children with USCP have been investigated in numerous studies, to our knowledge, no previous research has directly compared the effects of bilateral PNF-based strengthening exercises and plyometric training. Incorporating PNF patterns into upper extremity rehabilitation programs has been previously recommended, and examining the efficacy of these exercises in comparison with plyometric training may contribute valuable insights to the literature and inform clinical practice.

Inclusion Criteria:

• Aged between 5 and 12 years
• Diagnosed with unilateral spastic type cerebral palsy
• Classified as Level I or II according to the Gross Motor Function Classification System (GMFCS)
• Classified as Level I or II according to the Manual Ability Classification System (MACS)
• Upper extremity muscle tone ≤2 on the Modified Ashworth Scale
• Willing to suspend other upper extremity therapeutic interventions during the study period
• Able to cooperate and follow instructions provided by the researcher
• Voluntarily willing to participate in the study

Exclusion Criteria:

• History of any upper extremity surgery or Botulinum toxin (Btx) injection within the past 6 months
• Presence of an additional neurological disorder other than cerebral palsy
• Having visual and/or hearing impairments
• Having severe contractures that limit participation in functional activities