Effects of Upperlimb Sensorimotor Training in Hemiplegic Cerebral Palsy

Study Overview
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Brief Summary
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The study aims to determine the effects of upper limb sensorimotor training as compared to task oriented raining in subjects with cerebral palsy. The study will target the upperlimb functions using multiple outcomes and will find the changes in subjects undergoing sensorimotor or task oriented training.

Detailed Description
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The stduy will include subjects fulfilling the inclusion criteria, will be divided into 2 groups; interventional and control. The interventional group will be recieving sensorimotor training comprising of sensory activities and motor activities. The control group will be having motor activities in the form of task oriented training. The duration of intervention would be 40 minutes in each group, 3 days a week, for 8 weeks.

Official Title
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Effects of Upperlimb Sensorimotor Training in Hemiplegic Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Sensory training
* Other: Motor training
* Other: Conventional exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hemiplegic cerebral palsy Modified Ashworth scale score 2 and 3 Exclusion Criteria: Other neurological disorders Previous upper limb surgeries Botox injection in last 1 year

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 12 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
Interventional Model Description: 2 group parallel randomized control trial; both groups will be recruited and provided with interventions in parallel
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: interventional group<br>Superficial and Deep Sensory training: 5 sets of 9 min, 3 times a week for 8 weeks. Motor training: 5 sets of 9 min, 3 times a week for 8 weeks. Conventional therapy: 30 min, 3 days for 8 weeks | Other: Sensory training<br>* sensory training includes superficial sensory and deep sensory activities i.e. play with dough, painting with finger, recognizing objects with blocked vision, recognizing the drawn figure on palm, oint compression, bearing the weight on the paretic hand, leaning on the paretic side, walking with hand, rolling the heavy objects, dough squeezing etc.<br>Other: Motor training<br>* Motor training would involve activitoes such as throwing and catching a ball, targeted ball throwing, hand in hand ball transferring, ball rolling, hitting a ball to ground and wall, hand roller etc.<br>Other: Conventional exercises<br>* stretching exercises, muscle strengthening exercises, static weight bearing exercises, positioning<br>|
| Active Comparator: control group<br>Motor training: 5 sets of 9 min, 3 times a week for 8 weeks. Conventional therapy: 30 min, 3 days for 8 weeks | Other: Motor training<br>* Motor training would involve activitoes such as throwing and catching a ball, targeted ball throwing, hand in hand ball transferring, ball rolling, hitting a ball to ground and wall, hand roller etc.<br>Other: Conventional exercises<br>* stretching exercises, muscle strengthening exercises, static weight bearing exercises, positioning<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Ashworth Scale (MAS) | Modified Ashworth Scale measures the level of spasticity, ranging from 0-4 with 0 being no increase in tone and 4 being affected parts rigid in flexion | Baseline | 
| Modified Ashworth Scale (MAS) | Modified Ashworth Scale measures the level of spasticity, ranging from 0-4 with 0 being no increase in tone and 4 being affected parts rigid in flexion | After 4 weeks | 
| Modified Ashworth Scale (MAS) | Modified Ashworth Scale measures the level of spasticity, ranging from 0-4 with 0 being no increase in tone and 4 being affected parts rigid in flexion | After 8 weeks | 
| Finger Joint Position Sense | Finger Joint Position Sense is done to determine the sense of position, in whcih the subjet's finger is moved by the outcome assesser with eyes closed. | Baseline | 
| Finger Joint Position Sense | Finger Joint Position Sense is done to determine the sense of position, in whcih the subjet's finger is moved by the outcome assesser with eyes closed. | After 4 weeks | 
| Finger Joint Position Sense | Finger Joint Position Sense is done to determine the sense of position, in whcih the subjet's finger is moved by the outcome assesser with eyes closed. | After 8 weeks | 
| Manual ability classification system | Manual ability classification system is used to determine daily use hand activities | Baseline | 
| Manual ability classification system | Manual ability classification system is used to determine daily use hand activities | After 4 weeks | 
| Manual ability classification system | Manual ability classification system is used to determine daily use hand activities | After 8 weeks | 
| Manual Muscle Testing | Manual Muscle Testing is used to determine the strength. the score varies from 0-5; 0 means no contraction and 5 means movement aagainst maximum resistance | Baseline | 
| Manual Muscle Testing | Manual Muscle Testing is used to determine the strength. the score varies from 0-5; 0 means no contraction and 5 means movement aagainst maximum resistance | After 4 weeks | 
| Manual Muscle Testing | Manual Muscle Testing is used to determine the strength. the score varies from 0-5; 0 means no contraction and 5 means movement aagainst maximum resistance | After 8 weeks | 
| Abilities of Hand (ABILHAND-KIDS) | This tool is used to determine the hand and manual abilities of the kids. It has 21 manual activites with 3 levels each; 1 as impossible, 2 difficult and 3 easy. | Baseline | 
| Abilities of Hand (ABILHAND-KIDS) | This tool is used to determine the hand and manual abilities of the kids. It has 21 manual activites with 3 levels each; 1 as impossible, 2 difficult and 3 easy. | After 4 weeks | 
| Abilities of Hand (ABILHAND-KIDS) | This tool is used to determine the hand and manual abilities of the kids. It has 21 manual activites with 3 levels each; 1 as impossible, 2 difficult and 3 easy. | After 8 weeks | 
| Pediatric Arm Function Test | This is used to determine the upper extremity movement patterns in playful situation. It has 26 items with each at 6 levels ranging from minimum to maximum function. | Baseline | 
| Pediatric Arm Function Test | This is used to determine the upper extremity movement patterns in playful situation. It has 26 items with each at 6 levels ranging from minimum to maximum function. | After 4 weeks | 
| Pediatric Arm Function Test | This is used to determine the upper extremity movement patterns in playful situation. It has 26 items with each at 6 levels ranging from minimum to maximum function. | After 8 weeks |