Carry-Over Effects of Lower Limb Cross-Training Priming on Upper Limb Function in Children With Unilateral Cerebral Palsy (CROSS-UP)

April 7, 2026 updated by: Tamer Mohamed El-Saeed, Cairo University

Carry-Over Effects of Lower Limb Cross-Training Priming on Upper Limb Function in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial

PURPOSE:

The purpose of this randomized controlled trial was to investigate the potential carry-over effects of a 6-week lower limb strengthening-based cross-training (CT) priming protocol, added to standard physical rehabilitation, on affected upper limb function in children aged 6-8 years with unilateral cerebral palsy (UCP), compared to standard physical rehabilitation alone.

BACKGROUND:

Children with unilateral cerebral palsy (UCP) experience motor impairments affecting both lower and upper limbs, significantly impacting functional independence. While rehabilitation often targets specific limbs, interventions may induce broader neuroplastic changes. Movement-based priming, particularly strengthening-based cross-training (CT) targeting the less-affected limb, has shown promise for improving contralateral lower limb function in UCP, likely via cross-education mechanisms involving central nervous system adaptations. However, it remains largely unexplored whether such lower limb-focused priming interventions can induce secondary "carry-over" effects, positively influencing the function of the ipsilaterally affected upper limb through potential mechanisms like widespread neural adaptations or improved postural stability. Addressing this gap is crucial for understanding the holistic impact of priming interventions and optimizing rehabilitation strategies.

HYPOTHESES:

There will be no statistically significant difference in the improvement of affected handgrip strength, grasping skills and functional UL Outcome Measure between children receiving lower limb CT priming plus standard rehabilitation and those receiving standard rehabilitation alone over the 6-week intervention period.

RESEARCH QUESTION:

Does the addition of a 6-week lower limb strengthening-based cross-training priming protocol to standard physical rehabilitation result in significantly greater improvements in affected upper limb function (specifically handgrip strength and grasping skills) compared to standard physical rehabilitation alone in children aged 6-8 years with unilateral cerebral palsy?

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

40

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 Locations

  • Egypt
    • Cairo Governorate
      • Giza, Cairo Governorate, Egypt, 12613
        • Faculty of physical therapy, Cairo University

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:

  • Mild spasticity (MAS 1 or 1+), independent ambulation (AFOs permitted), and the ability to follow simple instructions.

Exclusion Criteria:

  • Children with significant fixed deformities, cognitive or sensory impairments hindering participation, uncontrolled epilepsy, or recent interventions like botulinum toxin or orthopedic surgery.

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Standard Rehabilitation Only
Children receive 60 minutes of standard physical rehabilitation targeting motor function, 3 sessions per week for 6 weeks, with no lower limb cross-training priming.
Other: Standard rehabilitation program
60-minute physical therapy program including strengthening, balance, and functional activities for children with unilateral cerebral palsy.
Experimental: Lower Limb Cross-Training Priming + Standard Rehabilitation
Children receive 10-15 minutes of lower limb strengthening-based cross-training priming of the less-affected limb, immediately followed by the same 60-minute standard rehabilitation program, 3 sessions per week for 6 weeks.
Other: Standard rehabilitation program
60-minute physical therapy program including strengthening, balance, and functional activities for children with unilateral cerebral palsy.
Other: Lower Limb Cross-Training Priming
10-15 minutes of lower limb strengthening-based cross-training of the less-affected limb used as movement-based priming prior to standard rehabilitation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Handgrip Strength (HGS)
Time Frame: Baseline and after 6 weeks of training
Handgrip strength measured by Jamar hand dynamometer
Baseline and after 6 weeks of training

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Peabody Developmental Motor Scales-2, Fine Motor subtest (PDMS-2 FM) - Grasping Age Equivalent
Time Frame: Baseline and after 6 weeks of training
Grasping age equivalent measured by Peabody Developmental Motor Scales-2, Fine Motor subtest (PDMS-2 FM)
Baseline and after 6 weeks of training

Collaborators and Investigators

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

Sponsor

Cairo 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)

January 1, 2026

Primary Completion (Actual)

March 30, 2026

Study Completion (Actual)

March 31, 2026

Study Registration Dates

First Submitted

March 31, 2026

First Submitted That Met QC Criteria

April 7, 2026

First Posted (Actual)

April 13, 2026

Study Record Updates

Last Update Posted (Actual)

April 13, 2026

Last Update Submitted That Met QC Criteria

April 7, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/006149

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There is currently no plan to share de-identified individual participant data (IPD) from this trial outside the primary research group.

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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