Effects of PNF and Rebound Therapy on Trunk Control in CP

January 28, 2024 updated by: Riphah International University

Effects of Proprioceptive Neuromuscular Facilitation Techniques With and Without Rebound Therapy on Trunk Control in Children With Cerebral Palsy

Cerebral palsy is a group of upper motor neuron syndromes with acquired disorders of early brain development .It effects the person's ability to move and maintain balance and posture. It is the most common motor disability of childhood. Proprioceptive neuromuscular facilitation integration pattern stimulates the proprioceptors with in the muscle and tendon to enhance the performance flexibility, balance and helps in trunk mobility. The motor control movement pattern is facilitated by the dynamic and assistive active resistant progressions regaining motor control. Rebound therapy is used to facilitate movement, promote balance, helps in increase or decrease in muscle tone and promotes sensory integration.

This study will evaluate the effects of PNF techniques with and without rebound therapy on trunk control in children with cerebral palsy. It is randomized controlled trial.34 children with cerebral palsy will participate in this study. The participants will be randomized into control group A (n=17) and experimental group (n =17).Only those children will be included who fulfill inclusion criteria. That is both gender, age range 6 to 12 years, having GMFM score of I -II .Those having cognitive and learning difficulties, having age range out of 6 to 12 years. Data will be analyzed through SPSS 29. The control group will practice PNF techniques for trunk control while experimental group will practice rebound therapy along with PNF exercises for trunk control .Both group will receive 45 min session, 5 days a week for 6 weeks. TCMS and TUG scale will be used.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Intervention

GROUP A (experimental group)

After giving baseline therapy experimental group will be given PNF based exercises for trunk control along with rebound therapy .duration will be 45 minutes, 5 session per week for 6 weeks.

PNF exercises will be;

Resist the person's concentric contraction while they move into sitting .Resist the eccentric control as they lie down. Balancing using stabilizing reversals or rhythmic stabilization to increase trunk stability .Resist the shoulder pelvis and head. For Trunk exercises: use dynamic reversals (slow reversals) and combination of isotonic to increase patient trunk strength and coordination .Resist at scapula and lifting combinations to get added irradiation. Trunk flexion and extension. Reaching forward and to the side with return, this requires hip flexion, extension ,lateral motion and rotation with the trunk remaining stable Bridging exercises Lower trunk rotation .Weight shifting in long leg sitting.

REBOUND THERAPY

Rebound therapy session including lying down on trampoline bouncing created by therapist.

It will be 10 repetitions. .Hip kneeling bouncing with physio balls. Standing bouncing with physio balls .Jumping on trampoline. Learning front drops, seat drops, and other function movements will be given for 5 minutes.

GROUP B (control group)

The control group will only be given PNF based trunk exercises. PNF exercises will be; Resist the person's concentric contraction while they move into sitting .Resist the eccentric control as they lie down. Balancing using stabilizing reversals or rhythmic stabilization to increase trunk stability .Resist the shoulder pelvis and head. For Trunk exercises: use dynamic reversals (slow reversals) and combination of isotonic to increase patient trunk strength and coordination .Resist at scapula and lifting combinations to get added irradiation. Trunk flexion and extension. Reaching forward and to the side with return, this requires hip flexion , extension ,lateral motion and rotation with the trunk remaining stable Bridging exercises Lower trunk rotation .Weight shifting in long leg sitting.

Study Type

Interventional

Enrollment (Estimated)

34

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Both gender
  • Children from 6 years to 12 years of age will be included
  • Degree of spasticity ranged from 1 and 1+ according to modified Ashworth scale
  • According to gross motor functional classification system children were categorized on level I -II
  • Those children should understand and follow simple orders.

Exclusion Criteria:

  • Child having any fixed deformity of both hands and feet.
  • Having hearing or visual disability
  • Having infectious disease or any open wound
  • Seizures
  • Other spinal deformities
  • Any fracture
  • Unstable cardiac status, Fever greater than 38 degrees Celsius, Any chest infection

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Proprioceptive neuromuscular facilitation techniques

GROUP A (experimental group)

PNF based exercises for trunk control duration 45 min 5 session/week for 6 weeks; Resist person concentric contraction while move in sitting .Resist eccentric control as th lie down. Balance using stabilizing reversals or rhythmic stabilization .Resist shoulder pelvis ,head.Trunk exercises dynamic reversals and combination of isotonic to increase trunk strength and coordination .Resist at scapula and lifting combinations for irradiation. Trunk flexion and extension. Reaching forward and to side with return,for this hip flexion, extension ,lateral motion and rotation with the trunk remaining stable Bridging exercises Lower trunk rotation .Weight shifting in long leg sitting
Other: Proprioceptive neuromuscular facilitation techniques
Proprioceptive neuromuscular facilitation techniques
Active Comparator: Rebound Therapy

Rebound Therapy lying down on trampoline bouncing created.10 times.Hip kneeling bounce and Standing bouncing with physio balls .Jump on trampoline. Learning front drops, seat drops for 5 minutes.

Resist person concentric contraction while move into sitting .Resist eccentric control as they lie down. Balance using stabilizing reversals to increase trunk stability .Resist shoulder pelvis, head.Trunk exercises: use dynamic reversals and combination of isotonic to increase trunk strength and coordination .Resist at scapula and lifting combination for irradiation. Trunk flexion and extension. Reaching forward and to side with return,for this hip flexion , extension ,lateral motion and rotation with trunk remaining stable Bridging exercises Lower trunk rotation .Weight shifting in long leg sitting
Other: Rebound Therapy
Rebound Therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trunk control measure scale
Time Frame: 6 weeks

Trunk control measuring scale TCMS:

Trunk control measuring scale is highly reliable in children with various neuromuscular disorders .It is reliable for children 5 years and older. TCMS consist of static and dynamic

sitting balance, the latter is divided into selective movement control and dynamic reaching.

TCMS is a valid and reliable tool for assessing the trunk control in children and youth with CP. The TCMS scale assesses seated trunk control in three dimensions. The maximum score is 58 points where 20 points correspond to static balance, 28 to selective movement control and 10 to the ability to perform dynamic reaching. The items are scored 0 to 3 with 0 being the inability to perform the task and 3 being the complete task performance.
6 weeks
Timed Up and Go test
Time Frame: 6 weeks

Timed Up and Go test (TUG)

It is a performance measure designed to assess the speed of a functional walk. It included stand up, walk 3 min, turn around, walk back, and sit down .It assesses lower limb mobility and function. The TUG test is reliable and responsive measure of balance and mobility for children with CP between 3 and 10 years of age and with GMFM level I- III
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Maidah Aiman, MS*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2023

Primary Completion (Estimated)

February 5, 2024

Study Completion (Estimated)

February 6, 2024

Study Registration Dates

First Submitted

December 26, 2023

First Submitted That Met QC Criteria

December 26, 2023

First Posted (Actual)

January 9, 2024

Study Record Updates

Last Update Posted (Actual)

January 30, 2024

Last Update Submitted That Met QC Criteria

January 28, 2024

Last Verified

January 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/23/0739

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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