Task Oriented Training on Static Versus Dynamic Surface on Balance in CP

Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture and movement which are due to a non-progressive interference, lesion, or abnormality of the developing/immature brain . It is clinically categorized into four groups according to the predominant motor syndrome: extra-pyramidal or dys-kinetic, spastic quadriplegia and spastic diplegia. The purpose of this current study is to determine the effect of a selected task-oriented training on balance and functional mobility in children with cerebral palsy. This will be a randomized clinical trial, data will be collected from Elite Physio and Special children center from Faisalabad. Study will be conducted on 22 patients.

Inclusion criteria of this study is children who can walk with or without walking aids from age between 6 to 12 years old. Cerebral palsy children who has any musculoskeletal deformity in any of two limb, visual auditory, perceptual and auditory deficits, seizures or epilepsy , having botulinum toxin injections will be excluded.

Group A will be provided with task oriented exercise training on dynamic surface.

Group B will be provided with task oriented exercise training on static surface.Pre and post session balance and functional mobility will be assessed by Time up and Go scale and Functional Mobility scale.

Flow diagram for study data collection procedure (According to CONSORT guidelines) in case of an RCT.All the referred patient will be assessed for the eligibility criteria. Guardians of the patient will be asked to sign the consent .All the screened participents will be randomly allocated into two groups.( Group A TOET on dynamic surface) , (Group B TOET on static surface)

Group A: Dynamic surface group:

This group will be provided with task specific exercise training on dynamic surface in cerebral palsy. Following exercises will be performed in this group: Make the child bounce on swiss ball, reaching the toy with both hand kept over the head on platform swing, high sitting on swiss ball throwing ball with both hands, reaching the toy with one hand shifting the wait towards reaching side. Exercise will be conducted 3 times per week for 8 weeks, pre and post session functional mobility will be measured by functional mobility scale and balance will be measured by Time up and Go test.

Group B: Static surface group:

This group will be provided with task specific exercise training on static surface in cerebral palsy. The children in this group will receive following TOET: Sit to stand from various cjair heights , standing and reaching indifferent directions for an object, Stepping forwards, backwards, and sideways onto blocks of various heights, walking forward , backward and sideways, Walking up and down stairs. Exercise will be conducted 3 times per week for 8 weeks, pre and post session functional mobility will be measured by functional mobility scale and balance will be measured by Time up and Go test

Eligibility Criteria:
Inclusion Criteria:

* Children with cerebral palsy
* Age between 6 to 12 years
* Children with GMFCS level I and II

Exclusion Criteria:

* CP children who has any musculoskeletal deformity in any of two limb
* Visual auditory, perceptual and auditory deficits, seizures or epilepsy
* Having botulinum toxin injections