Effects of Theraplay on Hand in Cerebral Palsy

Effects of Tharaplay Program on Hand Dexterity in Children With Hemiplegic Cerebral Palsy

Among the neurological conditions known as cerebral palsy are those that impact muscle tone, mobility, and cooperation. Cerebral palsy that affects only one side of the body is known as hemiplegic cerebral palsy. Damage to one side of the brain causes this disorder, which usually manifests as before, in the middle of, or soon after birth. The ability to use one's hands with coordination and expertise to accomplish tasks that call for control and accuracy is known as hand dexterity. For those who have cerebral palsy, hand dexterity can be a major issue. Developing hand dexterity is crucial as it might augment an individual's capacity to execute routine tasks and attain greater autonomy.Convenient sampling will be used to carry out a randomized control study.

Twenty two subjects will be divided into two groups at random. The experimental group will receive Theraplay therapy, which is a program that includes various play-based activities like playing with wooden puzzles, clay and blocks, making wraps, bubble tennis, and special handshakes, claps, and high fives, in addition to designed conventional therapy. The control group will receive designed conventional physical therapy exercises for the affected hand, such as hand weight-bearing exercises, stretching and strengthening exercises, and exercises using sponge balls.

The course of treatment will run for eight weeks. As outcome measures, the GMFCS and MACS scales, the box and block test, finger tapping, and the nine-hole peg test will be employed.

Data will be analyzed on SPSS version 25; the normality of the data will be checked and tests will be applied according to the normality of the data either it will be a parametric test or non parametric based on the normality.

Study Overview

• Status: Completed
• Conditions: Hemiplegic Cerebral Palsy
• Intervention / Treatment: Other: conventional physical therapy; Other: theraplay program

Detailed Description

Group A: The control group will receive a designed conventional physical therapy program for the affected hand like stretching and strengthening exercises, sponge ball exercises to the hand, and hand weight bearing exercises.

Group B: The experimental group will receive Theraplay therapy or a program and different play-based activities like playing with wooden puzzles and playing with clay and blocks, special handshake claps high fives, making wraps, and bubble tennis in addition to designed conventional therapy.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 54000
      • Riphah International University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Ages of both boys and girls range from 6 to 12 years
• Based on the Modified Ashworth Scale, the degree of spasticity is between 1 and 1+.
• Capable of grasping, releasing, and reaching with the afflicted hand
• Capable of comprehending and adhering to instructions

Exclusion Criteria:

• Children with mixed C.P., ataxic, athetoid, and mental retardation
• Visual and auditory issues
• Upper limb congenital malformations, Convulsions
• Youngsters who have recently sustained upper extremity trauma

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: conventional therapy; The control group will receive a designed conventional physical therapy program for the affected hand like stretching and strengthening exercises, sponge ball exercises to the hand, and hand weight bearing exercises.	Other: conventional physical therapy; conventional physical therapy program for like stretching and strengthening exercises, sponge ball exercises to the hand, and hand weight bearing exercises
Experimental: conventional therapy along with theraplay program; The experimental group will receive Theraplay therapy or a program and different play-based activities like playing with wooden puzzles and playing with clay and blocks, special handshake claps high fives, making wraps, and bubble tennis in addition to designed conventional therapy.	Other: theraplay program; A play therapy method called "thermaplay" aids in children's development of stronger bonds and relationships with others. It emphasizes the parts of communication that are nonverbal. When it comes to giving cerebral palsy children with hand therapy that is both effective and motivating, fun approaches have been shown to be both successful and appealing.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
modified ashworth scale	The Modified Ashworth Scale (MAS) is a commonly used clinical assessment tool to evaluate muscle tone and spasticity in individuals with neurological conditions such as spastic cerebral palsy. It is a reliable and valid method for grading muscle resistance during passive movement. interrater reliability of AS and MAS varied from moderate to good. ICC scores of AS were between 0.54 and 0.78 and MAS were between 0.61-0.87. Test-retest results of AS and MAS varied from poor to good. ICC values were between 0.31 and 0.82 for AS and between 0.36 and 0.83 for MAS.	8 weeks
ABILHAND-KID	a clinical instrument for assessing children with cerebral palsy's physical dexterity. The parents rated 21 largely bimanual elements that made up the ABILHAND-Kids scale. Because the parents gave a more accurate assessment of their kids' abilities than the kids did, the measurement range was larger, the reliability (R=0.94) was higher, and the results were consistent over time.	8 Weeks
Manual Ability Classification scale	The purpose of the Manual Ability Classification System is to categorize the ways in which kids with cerebral palsy use their hands to handle items during everyday tasks. The categorization is intended to represent the child's average manual performance rather than their maximum ability. There are five levels to it.	8 weeks
Gross Motor Functional Classification Scale	The most widely used scale by pediatric professionals to characterize the degree of gross motor impairment in children with cerebral palsy is the GMFCS. The five-level Gross Motor Function Classification System is used to categorize children with cerebral palsy according to their current gross motor ability, their limits in gross motor function, and whether or not they require assistive technology or wheeled mobility.	8 weeks
Box And Block Test	During therapy, a functional test called the Box and Blocks Test is performed to gauge a child with cerebral palsy's gross manual dexterity. The exam consists of a box with a center partition.	8 weeks
Nine Hole Peg Test	Patients with cerebral palsy can have their finger dexterity measured with the Nine Hole Peg Test.The patient picks up each of the nine pegs as fast as they can and inserts them into the nine holes in this test using a start command that starts a stopwatch.	8 weeks
Finger Tapping Test	The Finger Tapping Test, sometimes called the Tapping Speed Assessment, is one of the many tools available to assess motor control and the condition of the neuromuscular system.	8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: sidra jamal, MS, Riphah International University

Publications and helpful links

General Publications

• Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165. eCollection 2020.
• Tahsin Z. Effect of hand activities group therapy program on ADL performance of children with cerebral palsy at CENTRE FOR THE REHABILITATION OF THE PARALYSED (CRP): Bangladesh Health Professions Institute, Faculty of Medicine, the University …; 2019.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2024
• Primary Completion (Actual): August 1, 2024
• Study Completion (Actual): August 8, 2024

Study Registration Dates

• First Submitted: June 11, 2024
• First Submitted That Met QC Criteria: July 15, 2024
• First Posted (Actual): July 16, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 20, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: hand dexterity; cp; theraplay
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Cerebral Palsy
• Other Study ID Numbers: REC/RCR&AHS/23/0777

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