Arm Ergometer Versus Stabilization Exercises on Trunk Control and Upper Extremity Functions in cp

Study Overview
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Brief Summary
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The purposes of the current study are to: Define and compare between the efficacy of arm ergometer versus stabilization exercises on trunk control, hand grip power and upper limb quality of functions in children with diplegia.

Detailed Description
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Studies have shown that the cycle ergometer exercise improves several parameters, such as muscle strength and endurance, along with torso control in sitting position. However, these results are presented only in a small sample. Studies with the use of cycle ergometer in the population with CP are still few and present little information about the physiological effects .Previous studies on children with CP focused on the effect of ergometer on the upper and lower extremities functions. Limited literature is available regarding the effect of arm ergometer on trunk control among this population. The current study will be carried out to define the effect of arm ergometer versus stabilization exercises on trunk control, hand grip power, upper limb function in children with diplegia.

Official Title
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Effect of Arm Ergometer Versus Stabilization Exercises on Trunk Control and Upper Extremity Functions in Children With Diplegia

Conditions
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Spastic Diplegia

Intervention / Treatment
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* Device: Arm ergometer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ranges from six to ten years. Grade of spasticity 1 to 2 according to Modified Ashworth scale. Level II and III according to gross motor functional classification system. Level I-III according to manual ability classification system. Able to follow verbal commands and instructions included in both test and training. Exclusion Criteria: Significant visual or auditory problems according to medical reports (audio-vestibular and ophthalmic examination). Structural or fixed soft tissue deformities of the upper extremities. Neurological or orthopedic surgery in the past 12 months in the upper extremities. Botox injection in the upper extremities in the past 6 months.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm ergometer<br>Children in group I will receive strength-endurance protocol of arm ergometer for 30 minutes in addition to the conventional physical therapy program for 30 minutes, per session, three times a week, for three consecutive months. | Device: Arm ergometer<br>* The conventional physical therapy program included three sets of exercises as follows: Flexibility exercises to restore joint mobility of soft tissues. Static and dynamic balance exercise. Functional walking exercises.<br>* Other names: Stabilization exercises on BOSU ball;|
| Experimental: Trunk stabilization exercise<br>Children in group II will receive trunk stabilization exercises for 30 minutes in addition to the conventional physical therapy program for 30 minutes, per session, three times a week, for three consecutive months. | Device: Arm ergometer<br>* The conventional physical therapy program included three sets of exercises as follows: Flexibility exercises to restore joint mobility of soft tissues. Static and dynamic balance exercise. Functional walking exercises.<br>* Other names: Stabilization exercises on BOSU ball;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trunk control | Trunk control measurement scale includes 15 items that assess two main components of trunk control: static and dynamic sitting balance. While the total score is between 0 and 58, higher scores indicate a better level of performance. | 30 minutes | 
| Upper extremity functions | Quality of upper extremity scale test which consist 34 items in four main domains: dissociated movement, grasp, protective extension, and weight bearing. | 30/45 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hand grip strength | Hand held dynamometer used to measure muscle strength of the arm and hand in children with spastic CP. It is used to measure strength; maximal voluntary isometric contraction; objectively in kilograms, pounds or newtons. | 5 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral palsy / Arm ergometer