Effects of Mirror Therapy Combined With Progressive Strength Training in Unilateral Spastic Cerebral Palsy
Condition: Spastic Hemiplegic Cerebral Palsy
MeSH terms: Muscle Spasticity; Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      The purpose of this study is to investigate the effects of mirror therapy combined with upper
      extremity strengthening training on upper extremity function in children with unilateral
      spastic Cerebral Palsy (CP): a single blind randomized controlled trial. In the literature,
      there was no randomized controlled trial. According to literature, there are few studies that
      investigate the effects of mirror therapy in children with CP. But there is no randomized
      controlled trial, explore the effects of mirror therapy combined with upper extremity
      strength training on upper extremity functions in unilateral spastic CP. Hypothesis of this
      study is that mirror therapy combined with strength training improves upper extremity
      function and muscle strength in unilateral spastic CP.
    

Detailed description: 
      Cerebral Palsy (CP) is a permanent but not progressive disorder of motor function and
      movement/posture that caused by lesion in the immature brain. Children with hemiplegic CP
      have unilateral motor disorder affecting the right or left half of the body. They constitute
      42% of all CP. motor impairment of the upper extremity usually occurs more than the lower
      extremity. This motor impairment of upper extremity is one of the main reasons of the muscle
      weakness in children with unilateral CP. Nowadays studies has been proven to increase the
      activity and the body structure and function without any negative effect of strengthening
      education in children with CP. Park & Kim showed that huge impact of the upper and lower
      reinforcement training on children with CP the current meta-analysis (d = 0.861).

      To improve upper extremity function in children with unilateral CP, the mirror therapy is a
      promising approach. Mirror therapy for the first time, Ramachandran et al. has described for
      the treatment of phantom pain in amputee. Also in unilateral spastic CP mirror therapy have
      indicated that visual illusion of functional limb provided by mirror can support healing. By
      means of visual feedback, modified vision and perception is stimulated plasticity the
      premotor cortex and developed reorganization. In the current studies, mirror therapy in
      hemiplegic patients, have been shown that improve the function and reduce the sensitivity of
      the hemi neglect. Gygax et al. have investigated the effects of mirror therapy on upper
      extremity function 10 children with unilateral spastic CP between 6-14 years. Consequently,
      the spontaneous use affected hand, the maximum grip force increase of 15% and is demonstrated
      that improve the upper extremity motor function.
    

Intervention name(s): control group; intervention group
Intervention type(s): Other; Other
Intervention description(s): We will apply traditional physiotherapy including upper limb exercises in three times a week for 12 week.; Participants allocated to the experimental group completed three times a week, 12-week mirror therapy combined with progressive strength training. This protocol consisted of mirror therapy with a mirror box, strength training with Thera-band and exercises for scapular dyskinesis. This intensity of training is approximately equal to training at an intensity of 60% to 80% of one-repetition maximum according to "National Strength and Conditioning Association (NSCA)" protocols. Intensity of exercise is gradually increased 10% bi-weekly.
Other intervention name(s): traditional therapy; mirror therapy and progressive strength training
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: cerebral palsy; mirror therapy; strength training