Unilateral Versus Bilateral Lower-Limb Plyometric Training in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study was set out to compare the effect of paretic-limb-only plyometric training versus
      double-limb training on balance capability and gait symmetry in adolescents with unilateral
      cerebral palsy (U-CP). Sixty-nine children with U-CP were randomly allocated to the
      paretic-limb-only plyometric training group (n = 23; performed plyometric movements/exercises
      unilaterally using the paretic leg only), the double-limb plyometric training group (n = 23;
      performed plyometric movements/exercises bilaterally through both lower legs), or the Control
      group (n =23, received standard rehabilitation plus SSC exercises). All groups were assessed
      for gait-symmetry and balance capability pre and post-treatment.
    

Detailed description: 
      Sixty-nine children with U-CP 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 level 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

        -  Gait-symmetry Indices: Gait symmetry indices (Spatial and temporal) were measured
           through the portable GAITRite system.

        -  Dynamic balance: The directional dynamic limit of stability (forward, backward, paretic,
           and non-paretic) and overall limit of stability were assessed using the Biodex balance
           system.

      All groups were trained for 45 minutes, twice per week, for 12 successive weeks. The
      paretic-limb-only plyometric training group performed plyometric movements/exercises
      unilaterally using the paretic leg only. The double-limb plyometric training group performed
      plyometric movements/exercises bilaterally through both lower legs. The plyometric training
      program consisted of five unilateral and five bilateral lower limb plyometrics in the form of
      hopping/bounding/jumping activities. The plyometric training was preceded by a warm-up for 5
      minutes and ended up with a 5-min cooldown. The control group received the standard
      rehabilitation program, which comprised advanced balance training, and gait training
      exercises, postural and flexibility exercises, strength training exercises.
    

Intervention name(s): Unilateral plyometric training; Bilateral plyometric training; Standard physical therapy
Intervention type(s): Other; Other; Other
Intervention description(s): The paretic-limb-only plyometric training group received a plyometric exercise program performed unilaterally through the paretic leg only for 45 minutes, three times per week for 12 successive weeks. The training was conducted under close supervision of a licensed pediatric physical therapist according to safety performance guidelines defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association.; The double-limb plyometric training group received a plyometric exercise program performed bilaterally through the paretic and non-paretic legs for 45 minutes, three times per week for 12 successive weeks. The training was conducted under close supervision of a licensed pediatric physical therapist according to safety performance guidelines defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association.; The control group received the standard physical rehabilitation program conducted for 45 minutes, thrice a week for 12 consecutive weeks, and consisted of advanced balance training, gait training, postural and flexibility exercises, and strength training exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, randomized controlled clinical trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment