Plyometric Exercise-induced Mechano-morphological Changes of Plantar Flexor Muscle-tendon Unit in Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study was designed to investigate the effect of three months of plyometric exercise
      training on the mechanical and morphological properties of the plantar flexor muscle-tendon
      unit in children with unilateral cerebral palsy (UCP). Thirty-eight children with UCP were
      randomly allocated to the plyometric exercise group (n = 19, underwent a plyometric training
      program) or the Control group (n =19, received usual physical rehabilitation alone). Both
      groups were assessed for the plantar flexors' morphological and mechanical properties before
      and after treatment.
    

Detailed description: 
      Thirty-eight children with CP participated in the study. They were recruited from King Khalid
      Hospital and Physical Therapy Center of College of Applied Medical Sciences at Prince Sattam
      bin Abdulaziz University, Al-Kharj, Saudi Arabia. Their age ranged between 10 and 16 years,
      were functioning at levels I or II according to the Gross Motor Function Classification
      System, and had spasticity level 1 or 1+ per the Modified Ashworth Scale. Children were
      excluded if they had nonreducible structural deformities, received neurolytic agents such as
      BOTOX or Phenol injections in the past six months, underwent neuromuscular or orthopedic
      surgery in the last 12 months, or if they had cardiopulmonary problems preventing them from
      performing high-intense exercise training.

      Outcome measures

        1. Plantar Flexors' Morphological Properties: length of gastrocnemius muscle-tendon unit,
           gastrocnemius muscle belly, and achilles, in addition to fascicle length, pennation
           angle, and gastrocnemius muscle thickness were assessed using a standard high-resolution
           ultrasound imaging system.

        2. Plantar Flexors' Mechanical Properties: Passive range of motion of the ankle joint and
           maximum isometric voluntary contraction were assessed using an isokinetic dynamometer.

      The plyometric exercise group received a 12-week plyometric training program. Each session
      lasted 45 minutes and was repeated two times a week. The training was conducted in conformity
      with the National Strength and Conditioning Association guidelines and American Academy of
      Pediatrics safety standards. The plyometric exercise program consisted of ten unilateral and
      bilateral lower limb plyometrics in the form of hopping/bounding/jumping activities. The
      Iplyometric workout was proceeded by a 5-minute warm-up and ended up with a 5-minute
      cool-down. The control group received their usual physical rehabilitation program for 45
      minutes, twice/week for 12 consecutive weeks. The program comprised advanced balance
      training, and gait training exercises, postural and flexibility exercises, strength training
      exercises.
    

Intervention name(s): Plyometric Exercises; Standard Physical Therapy
Intervention type(s): Other; Other
Intervention description(s): The plyometric exercise group received a 12-week plyometric training program. Each session lasted 45 minutes and was repeated two times a week. The training was conducted in conformity with the National Strength and Conditioning Association guidelines and American Academy of Pediatrics safety standards. The plyometric exercise program consisted of ten unilateral and bilateral lower limb plyometrics in the form of hopping/bounding/jumping activities. The Iplyometric workout was proceeded by a 5-minute warm-up and ended up with a 5-minute cool-down; The control group received their usual physical rehabilitation program for 45 minutes, twice/week for 12 consecutive weeks. The program comprised advanced balance training, and gait training exercises, postural and flexibility exercises, strength training exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective pre-test post-test randomized controlled trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment