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| Effectiveness of a multi-modal exercise program incorporating plyometric and balance training in children with hemiplegic cerebral palsy: a three-armed randomized clinical trial |
| Elnaggar RK, Mahmoud WS, Alsubaie SF, abd el-Nabie WA |
| Physical & Occupational Therapy in Pediatrics 2022;42(2):113-129 |
| clinical trial |
| 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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AIM: To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP). METHODS: A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group; n = 19), balance exercises (BAL group, n = 19), and combined plyometric and balance exercises (PLYO-BAL group; n = 19). The maximum isometric muscle strength (IMSmax) and postural stability (anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)) were measured pre- and post-intervention. RESULTS: By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMSmax than the PLYO and BAL groups for the quadriceps (p = 0.03 and p = 0.0002 respectively), hamstrings (p = 0.018 and p < 0.0001 respectively), and dorsiflexors (p = 0.006 and p < 0.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI (p < 0.0001 and p = 0.0001 respectively), ML-SI (p = 0.001 and p = 0.015 respectively), and O-SI (p = 0.011 and p = 0.04 respectively). CONCLUSIONS: Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP.
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