effect of callisthenic training on mobility and adl performance in spastic diplegic cerebral palsy patients

Conditions: Activities of Daily Living; Postural Control; Spasticity; Mobility

Summary: almost 2 to 3 out of every 1000 children have cerebral palsy in pakistan.spastic type of cp is dominant about 75%, diplegia (40%) and hemiplegic are (35.5%).spastic diplegics have tightness of lower limb more than upper limb.their chief complaints are reduced mobility,impaired balance and coordination and lack of postural control and stability.calisthenic training is sort of strengthening exercises in which patient use his/her own body weight as a resistance. calisthenic training aims to reduce movement limitation,contracture formation and improves patient's mobility for daily transfers and ambulation,active participation of patient in indoor and outdoor activities and enhance postural stability and controle during routine tasks. the current study aims to determine the effects of calisthenic training on mobility and adl performance in spastic diplegic cerebral palsy children aged 5-12 years fulfilling the gmfcs criteria levels 1-3. a randomized control trial will be conducted in multidisciplinary lab of fucp, department of physical medicine and peads and rehabilitation of fauji foundation hospital on the sample of 32 participants. the subjects will be randomized into two groups by sealed opaque envelope method. baseline assessment would be done by using weefim measurement assessment scale for mobility and adl performance, pediatric balance assessment scale for postural control. data will be collected at baseline before intervention, after 3 weeks and finally after 6 weeks of intervention. interventional group will be receiving calisthenic training and conventional physical therapy while control group will be receiving conventional physical therapy alone. exercise training would be done for a total of 12 sessions for 6 weeks, twice a week with each session lasting 45 minutes. analysis would be done by using spss version 21. ethical approval will be obtained from erc of fush. informed written consent will be obtained from all participants.

objectives of study 1. to determine the affects of callisthenic exercises in comparison to conventional physical therapy on mobility, adl perfrmance and quality of life in spastic diplegic cp children . 2. to determine the affects of callisthenic exercises in comparison to conventional physical therapy on postural controle in spastic diplegic cp hypothesis: alternate hypothesis: * affect of calisthenic training in comparison to conventional physical therapy on mobility in spastic diplegic cp patients (p\<0.05). * 2ha- there will be statistically significant difference in the affect of calisthenic training in comparison to conventional physical therapy to improve adl performance in spastic diplegic cp patients (p\<0.05). * 3ha- there will be statistically significant difference in the effect of calisthenic training in comparison to conventional physical therapy to improve postural controle in spastic diplegic cp patients (p\<0.05). null hypothesis * 1h0 -there will be no statistically significant difference in the effect of calisthenic training in comparison to conventional physical therapy to improve adl performance in spastic diplegic cp patients (p\<0.05). * 2h0 -there will be no statistically significant difference in the effect of calisthenic training in comparison to conventional physical therapy to improve mobility in spastic diplegic cp patients (p\<0.05). 3h0 -there will be no statistically significant difference in the effect of calisthenic trainingin comparison to conventional physical therapy to improve postural controle in spastic diplegic cp patients (p\<0.05). significanve of study: as there is no any conclusive evidence of calisthenic training more precisely for spastic diplegic cp children so this study will be helpful for patients and other health care proffessionals to implement this study in their clinical practice and for the patients in a way they can keep continue this treatment protocol in their home bound friendly environment by using their own body weights as a resistance after quiting from sessions of this research . it will provide a treatment protocol for targeting calisthenic training to improve mobility, incorporate postural corrections and functional capacitance in spastic cp children . this study will maximize the indoor functional independency in the cerebral palsy

Eligibility criteria:
inclusion criteria: * age between 5 and 13 years * able to accept and follow verbal instructions * able to participate in a training program * based on gross motor function classification system (gmfcs scale 1,2 and 3) exclusion criteria: * if they have controlled seizures * if they suffered from any inflammatory, infectious diseases, cognitive deficiencies and any musculoskeletal deformity with chronic contracture that interfere with physical activity.

Keywords: calisthenic training postural control conventional pt fes-i dynamic gait index tug berg balance scale older adults risk of fall functional mobility balance dual task training otago exercise program