Modified Constraint Induced Movement Therapy With And Without Cross Education In Cerebral Palsy
NCT Number: NCT06522464
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Cerebral Palsy
Interventions: OTHER: Group A: mCIMT with cross-education|OTHER: Group B: mCIMT without cross-education
Sponsor: Riphah International University
Sex: ALL
Age: CHILD
Enrollment: 22
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (PARTICIPANT)|Primary Purpose: TREATMENT
Start Date: 2024-06-30
Completion Date: 2024-10-30
Locations: Rich Care A Rehabilitation Clinic, Lahore, Punjab, 37110, Pakistan

Summary:
A nonprogressive injury to the growing brain, cerebral palsy can impair a child's speech, intellectual ability, and motor development. The kind of impairment will correspond with the affected brain region. Cross education is the process of improving one's strength or skill on the contralateral limb after undergoing unilateral training or practice. This is typically done with a mirror, which activates the mirror neuron on the ipsilateral side. CI, or Constraint-Induced Movement Therapy (CIMT), is a "rehabilitative strategy". It is intended to help people affected by stroke or other neurological problems utilize an affected extremity more functionally. It restrains the limb that is neurologically stronger while applying mass practice concepts. It has also been described as a behavioral approach to neurorehabilitation, with a focus on shaping as a recurring theme, and it uses basic behavioral approaches. The study's objective is to ascertain how cross-education using mCIMT affects cerebral palsy that is hemiparetic.

The Pakistan Society for the Rehabilitation of the Disabled, Lahore (PSRD), Rising Sun Institute for Special Children DHA, and ARK campus Lahore will all provide data for the present study, which is a randomized controlled experiment. Twenty-two volunteers will be randomly assigned to two equal groups for the study. Children with hemiperatic cerebral palsy, aged 6 to 12, of any gender, who have up to 20 degrees of wrist extension, 10 degrees of thumb abduction, and up to 10 degrees of finger extension are eligible to participate in the study. Exclusion criteria included significant shoulder subluxation, uncontrolled systemic hypertension, prior stroke, severe heart failure, and a mini mental state evaluation score of less than 24. The control group will receive conventional physical therapy, whereas the experimental group will receive cross-training using mCIMT and RPT. Result The results before and after the intervention will be analyzed using the Fugl Meyer Upper Extremity Scale and Upper Extremity Functional Index Scale, Jebsen-Taylor Hand Function Test, and Block and Box manual Dexterity Test. Data analysis will be conducted using SPSS version 23.00.

Primary Outcome Measures: Upper Extremity Functional Index Scale:, Patients with disabilities to their upper limbs can have their functional limitations evaluated using the UEFI. It can be used to track changes in functional status over time and assess how well treatment plans are working. Currently, UEFI 20-item and UEFI 15-item are the two versions available. The UEFI is designed to be used by people who have musculoskeletal dysfunction of the upper extremities (shoulder, elbow, wrist, and hand). The scores on the UEFI range from 0 to 4, where 0 denotes extreme difficulty and 4 denotes no difficulty at all. The total score is the sum of the individual scores. The possible range for the UEFI 20-item is 0 to 80, where 80 represents the highest functioning state and 0 the lowest., 10 weeks|Jebsen-Taylor Hand Function Test:, This standardized and objective test uses simulated activities of daily living (ADL) to assess fine and gross motor function in the hands. Writing, simulated page flipping, lifting tiny things, simulated feeding, stacking, and lifting large, light, and heavy objects are the seven subsets of the JTHFT. It is an accurate instrument for measuring hand dysfunctions in a range of patient demographics. The JTHFT takes 15 to 45 minutes to complete. Better performance is shown by shorter times., 10 weeks|Box and Block Test (BBT):, The BBT is made up of 150 blocks and a wooden box with a partition dividing it into two sections. requesting that the client transfer the greatest number of blocks, one by one, in 60 seconds from one box compartment to another of equal size. It is especially appropriate for kids for a number of reasons. First, the BBT assessment approach looks at basic manual dexterity skills for growing kids, like gripping, holding, transferring, and releasing. Second, the BBT's instructions are straightforward to understand, and the task itself is simple. Third, the job may be completed in just one minute, which is appropriate for the majority of children's attention spans., 10 weeks