Horizontal Versus Vertical Upper Extremity Function in Bilateral Cerebral Palsy

HORIZONTAL VERSUS VERTICAL UPPER EXTREMITY PERFORMANCE ON HAND SKILLS AND TRUNK CONTROL IN BILATERAL CEREBRAL PALSY

The goal of this quasi-experimental study is to investigate and compare the effects of horizontal and vertical upper extremity performance on hand skills and trunk control in children with bilateral spastic cerebral palsy; could include any of the following: both gender, age ranged from 5 years to 8 years. The main question it aims to answer [is/are]:

There will be no significant difference effect between horizontal and vertical upper extremity performance on hand skills and trunk control in children with bilateral spastic cerebral palsy.

Study Overview

• Status: Enrolling by invitation
• Conditions: Bilateral Cerebral Palsy
• Intervention / Treatment: Procedure: a designed occupational therapy (OT) program to improvement hand skills conducted on a horizontal surface.; Procedure: a designed occupational therapy program to improvement hand skills conducted on a vertical surface.

Detailed Description

This study aims to investigate the effects of to investigate and compare the effects of horizontal and vertical upper extremity performance on hand skills and trunk control in children with bilateral spastic cerebral palsy. The research will evaluate fine motor proficiency, upper extremity function and trunk stability from sitting through a controlled and structured intervention program.

Participants will undergo designed Occupational Therapy program will be applied for 90 minutes, three days per week for successive three months for the both groups by the researcher The study adopts a quasi-experimental design, with thirty participants allocated into two groups of an equal number, twenty children for each group. Two group will be identified as group (A) and group (B).

Data will be analyzed using paired t-test will be used for within group comparison before and after the intervention, for each variable and independent t-test was used to compare the demographic data and the baseline characteristics of both groups for all measured variables, pre and post treatments, with a significance level set at p < 0.05.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11511
    • Faculty of Physical Therapy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Children with BSCP, their chronological age will be ranged from 5 years to 8 years.
• Their level of motor function will be I or II according to Gross Motor Function Classification System - Expanded and Revised.
• The degree of spasticity for these children will ranged from grade 1 to 1⁺ according to Modified Ashworth Scale.
• Their level of fine motor function will be I or II according to The Bimanual Fine Motor Function.
• All children's level of segmental trunk control will be level 7 (full trunk control) according to Segmental Assessment of Trunk Control.
• They will be able to follow instructions during evaluation and treatment.

Exclusion Criteria:

• Surgical interference in upper limbs and/or spine that may restrain the child performance during activities.
• Orthopedic problems or fixed deformities in the vertebral column and/or upper extremities.
• Uncontrolled seizures.
• Visual or hearing impairment.
• Receiving special medication affecting muscle and /or mental function.

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: Group (A); Children in this group will receive a designed occupational therapy (OT) program to improvement hand skills conducted on a horizontal surface.	Procedure: a designed occupational therapy (OT) program to improvement hand skills conducted on a horizontal surface.; The treatment session will be started by the following exercises for 30 minutes as preparation for hand skill training and the second part of the session will be exercises facilitating fine motor skills a horizontal surface for one hour, Three sessions per week will last for 90 minutes, for successive Three months.
Experimental: Group (B); Children in this group will receive the same designed OT program given to group (A) conducted on a vertical surface.	Procedure: a designed occupational therapy program to improvement hand skills conducted on a vertical surface.; The treatment session will be started by the following exercises for 30 minutes as preparation for hand skill training and the second part of the session will be exercises facilitating fine motor skills a vertical surface for one hour, Three sessions per week will last for 90 minutes, for successive Three months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Fine motor proficiency	Evaluated using the fine motor form of the Bruinink-Oseretsky test for motor proficiency 2nd edition (BOT-2)	Before and after the three months of treatment
Change in upper extremity function	Evaluated using the Quality of Upper Extremity Skills Test (QUEST)	Before and after the three months of treatment
Change in trunk stability from sitting	Evaluated using the Trunk Control Measurement Scale (TCMS) to assess static and anticipatory trunk control	Before and after the three months of treatment

Collaborators and Investigators

• Sponsor: Raghda Gamal Ateya Abd-Elbary
• Investigators: Study Chair: Kamal El Sayed Shoukry, Professor Doctor, Department of physical therapy for growth and developmental disorder in children and its surgery, Faculty of physical therapy, Cairo University; Study Director: Nanees Essam Mohamed, Professor Doctor, Department of physical therapy for growth and developmental disorder in children and its surgery, Faculty of physical therapy, Cairo University; Study Director: Gehan Mosaad Abd El-Maksoud, Professor Doctor, Department of physical therapy for growth and developmental disorder in children and its surgery, Faculty of physical therapy, Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): June 16, 2025
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): December 30, 2026

Study Registration Dates

• First Submitted: January 18, 2026
• First Submitted That Met QC Criteria: January 18, 2026
• First Posted (Actual): January 26, 2026

Study Record Updates

• Last Update Posted (Actual): January 26, 2026
• Last Update Submitted That Met QC Criteria: January 18, 2026
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: P.T.REC/012/004404

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