The Role of Pilates, Plyometrics, and Their Combination for Children With Unilateral Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study was conducted to compare the effect of Pilates-based core strengthening (PsCS) and
      plyometric-based muscle loading (PlyoML) and their combination on postural control, balance,
      and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP
      were randomly allocated to the PsCS (n = 27), PlyoML (n = 27), or combined intervention (n =
      27) group. Participants in the three groups were assessed for postural control, balance, and
      mobility on the pre and post-treatment occasions.
    

Detailed description: 
      Eighty-one children with ULCP were recruited from the Physical Therapy Outpatient Clinic of
      College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, King Khalid
      Hospital, and a tertiary referral hospital, Al-Kharj, Saudi Arabia. Their age ranged between
      12 and 18 years, were functioning at levels I or II according to the Gross Motor Function
      Classification System, and had spasticity levels 1 or 1+ per the Modified Ashworth Scale.
      Children were excluded if they had fixed deformities, underwent neuromuscular or orthopedic
      surgery in the last 12 months, submitted to BOTOX injection in the past 6 months, had
      attentional neglect, and if they had cardiopulmonary problems preventing them from performing
      high-intense exercise training.

      Outcome measures

        -  Postural control: The directional dynamic limit of stability (forward, backward,
           paretic, and non-paretic) and overall limit of stability were assessed using the Biodex
           balance system.

        -  Balance and mobility: The Community Balance and Mobility Scale (CB&M), Functional
           Walking Test (FWT), and Timed Up and Down Stair test (TUDS) were used to quantify
           balance and mobility capacity.

      Interventions

      All groups were trained for 45 minutes, twice per week, for 12 successive weeks. The PsCS
      group performed eight Pilates exercises geared predominantly toward the core muscles. The
      PlyoML group performed 10 plyometric exercises primarily focused predominantly on the lower
      body. The combined group combined the same exercises as the PsCS and PlyoML groups, although
      with half the number of sets/repetitions.
    

Intervention name(s): Pilates-based Core Strengthening Exercises; Plyometric-based Muscle Loading Exercises; Combined Pilates and Plyometrics
Intervention type(s): Other; Other; Other
Intervention description(s): The PsCS group performed eight Pilates exercises over 45 minutes, three times per week for 12 successive weeks. The training was conducted under the supervision of a physical therapist who had more than 5 years of experience in Pilates.; The PlyoML group performed 10 plyometric exercises over 45 minutes, three times per week for 12 successive weeks. The training was conducted under the close supervision of a licensed pediatric physical therapist. The safety and performance guidelines, defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association, were considered during training.; The combined training group performed the same exercises as the PsCS and PlyoML groups, although with half the number of sets/repetitions over 45 minutes, three times per week for 12 successive weeks. The PsCS and PlyoML were executed within the same session, with a 10-to-15-minute rest interval. The training was conducted under the close supervision of a licensed pediatric physical therapist. The safety and performance guidelines, defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association, were considered during training.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, assessor-blinded, randomized study
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment