Effects of Swiss Ball vs Frenkle Exercises on Static and Dynamic Balance in Ataxic CP

NCT ID: NCT06673797

Last Updated: 2024-11-05

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 18 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-09-24
• Study Completion Date: 2024-12-10

Brief Summary

Several studies have highlighted the significant impact of cerebral palsy, a prevailing neurological and musculoskeletal developmental disorder among childhood disabilities worldwide. Within the spectrum of cerebral palsy, ataxic CP stands as the least prevalent type, accounting for 5 to 10% of all cases. Individuals diagnosed with ataxic CP encounter difficulties in fine motor skills, precision, and coordination, and exhibit an unsteady gait, some of which are linked to compromised postural control and inadequate core stability. These issues culminate in functional limitations, heightening the risk of falls, and further contributing to the overall disability experienced by the patients. Consequently, there exists a need to prioritize research and develop targeted treatment protocols specifically for ataxic CP. It is crucial to emphasize the enhancement of postural control and coordination, with particular emphasis on improving static and dynamic balance during rehabilitation. Implementing Swiss ball exercises and Frenkel exercises in the rehabilitation protocol for children with ataxic cerebral palsy can significantly diversify treatment strategies. These exercises play a pivotal role in supporting these children to either sustain or regain their ability to function independently, reduce the risk of falls, and notably improve their overall well-being.

Detailed Description

A four-week randomized clinical trial will involve 18 participants, divided randomly into two intervention groups, with nine participants in each group. Group A (intervention group 1) will participate in Swiss ball exercises combined with stretching, while Group B (intervention group 2) will partake in Frenkel exercises along with stretching. The sampling method employed will be a non-probability technique. The Pediatric Balance Scale (PBS) will serve as the primary tool for outcome measurement. Randomization will be conducted using computer-generated software. The study design will be single-blinded, ensuring the assessor remains unaware of the groups' assignments. Initial data collection (pretest) will occur at week 0, followed by post-test data collection at week 4. For intergroup analysis, if the data follows a normal distribution, the parametric Independent t-test will be utilized, enabling the calculation of mean, standard deviation, and p-values. Alternatively, if the data does not display a normal distribution, the non-parametric Mann-Whitney test will be employed, allowing the calculation of median, interquartile ranges, and p-values.

Conditions

Cerebral Palsy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Group A:The first intervention group would participate in Swiss ball exercises along with stretching

Group A: The first intervention group would participate in Swiss ball exercises along with stretching as baseline treatment. The exercises would be performed 3 times per week for four weeks. (12)

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times. (11)

1. Calf stretching

2. Hamstring stretches

3. Quad stretchings

2. 2. Swiss ball exercises

1. Sitting on the Swiss ball with the trunk straight, arms by the sides, and eyes opened progressed towards eyes closed for 10 seconds, then rest

2. Sitting on the Swiss ball with trunk straight and arm by the sides.

3. Standing with gym ball in front.

4. One leg weight bearing on a gym ball with the therapist behind the patient, gripping the patient's pelvis to provide support

Group Type: EXPERIMENTAL

Effects of Swiss Ball exercises

Intervention Type: OTHER

Effects of Swiss ball exercises along with stretching as baseline treatment.

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times.

2. Swiss ball exercises. a.Sitting on the Swiss ball with the trunk straight, arms by the sides, and eyes opened progressed towards eyes closed for 10 seconds, then rest. b.Sitting on the Swiss ball with trunk straight and arm by the sides. The therapist would assist the patient to engage the patient in shifting the body's weight to one side and the other side sideways as well as anterior and posterior and up and down alternatively. Start with 10 repetitions. c. Standing with gym ball in front. The therapist would stand behind the patient to provide support and ask the patient to lean forward on the gym ball with both hands via outstretched arms. Start with 10 repetitions d. One leg weight bearing on a gym ball with the therapist behind the patient, gripping the patient's pelvis to provide support. Start with 10 repetitions

Group B: The second intervention group would participate in Frenkel Exercises along with stretching.

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times. (11)

1. Calf stretching

2. Hamstring stretches

3. Quads stretching

2. Frenkel's lower limb exercises are the exercises listed below. The time of each session was set to be 10 minutes in the first week and then raised by 5 minutes every week. The patients were given 5 minutes to relax after 10 minutes of practice.

a. Supine lying: i. with the head lifted; Hip abduction and adduction ii. with the head lifted, and one hip and knee extended iii. with the head lifted; and extending one leg to position the heel on the designated spot b. While sitting: i. stretch one leg to the side, bringing the heel to a spot where a mark has been made on the floor.

ii. Stride sitting; Stand up from a seated position, then return to a seated position.

c. Stride standing: i. weight transfer from foot to foot. ii. stepping sideways with feet on floor markings. iii. turn around. iv. walking and turning to avoid obstacles.

Group Type: EXPERIMENTAL

EFFECTS OF FRENKEL EXERCISES ON STATIC AND DYNAMIC BALANCE IN ATAXIC CHILDREN WITH CEREBRAL PALSY

Intervention Type: OTHER

Frenkel Exercises along with stretching as baseline treatment. The second intervention group would participate in Frenkel Exercises along with stretching as baseline treatment. The exercises would be performed 3 times per week for four weeks.

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times. (11)

a. Calf stretching. b. Hamstring stretches. c. Quads stretching

2. Frenkel's lower limb exercises are the exercises listed below. The time of each session was set to be 10 minutes in the first week and then raised by 5 minutes every week. The patients were given 5 minutes to relax after 10 minutes of practice. (12)

1. Supine lying

2. While sitting

3. Stride standing

Interventions

Effects of Swiss Ball exercises

Effects of Swiss ball exercises along with stretching as baseline treatment.

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times.

2. Swiss ball exercises. a.Sitting on the Swiss ball with the trunk straight, arms by the sides, and eyes opened progressed towards eyes closed for 10 seconds, then rest. b.Sitting on the Swiss ball with trunk straight and arm by the sides. The therapist would assist the patient to engage the patient in shifting the body's weight to one side and the other side sideways as well as anterior and posterior and up and down alternatively. Start with 10 repetitions. c. Standing with gym ball in front. The therapist would stand behind the patient to provide support and ask the patient to lean forward on the gym ball with both hands via outstretched arms. Start with 10 repetitions d. One leg weight bearing on a gym ball with the therapist behind the patient, gripping the patient's pelvis to provide support. Start with 10 repetitions

Intervention Type: OTHER

EFFECTS OF FRENKEL EXERCISES ON STATIC AND DYNAMIC BALANCE IN ATAXIC CHILDREN WITH CEREBRAL PALSY

Frenkel Exercises along with stretching as baseline treatment. The second intervention group would participate in Frenkel Exercises along with stretching as baseline treatment. The exercises would be performed 3 times per week for four weeks.

1. Stretching of hamstrings, calf, and quads for 10 seconds hold 5 times. (11)

a. Calf stretching. b. Hamstring stretches. c. Quads stretching

2. Frenkel's lower limb exercises are the exercises listed below. The time of each session was set to be 10 minutes in the first week and then raised by 5 minutes every week. The patients were given 5 minutes to relax after 10 minutes of practice. (12)

1. Supine lying

2. While sitting

3. Stride standing

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients with having diagnosis of ataxic cerebral palsy
• Age between 5 to 8 years.
• GMFC level 2.
• Both the genders were included

Exclusion Criteria

• Visual Impairments and hearing loss
• Mental retardation
• Fixed contractures or deformities of the spine or extremities
• Meningitis

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 8 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Rana Ali Raza Shoukat, MS*

Role: PRINCIPAL_INVESTIGATOR

Riphah International Univerisity

Locations

Riphah international university

Lahore, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Imran Amjad, PhD

Role: CONTACT

Imran.amjad@riphah.edu.pk

9233224390125

Muhammad Asif Javed, MS

Role: CONTACT

a.javed@riphah.edu.pk

03224209422

Facility Contacts

Imran Amjad, PhD

Role: primary

Imran.amjad@riphah.edu.pk

9233224390125

Muhammad Asif Javed, MS

Role: backup

a.javed@riphah.edu.pk

03224209422

References

Pouliot-Laforte A, Parent A, Hamdy R, Marois P, Lemay M, Ballaz L. Relationship between lower limb strength and walking capacities in children with spastic bilateral cerebral palsy. Disabil Rehabil. 2022 May;44(10):1916-1922. doi: 10.1080/09638288.2020.1813819. Epub 2020 Sep 9.

Reference Type: BACKGROUND

PMID: 32905745 (View on PubMed)

Elshafey MA, Abdrabo MS, Elnaggar RK. Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy. J Musculoskelet Neuronal Interact. 2022 Jun 1;22(2):172-178.

Reference Type: BACKGROUND

PMID: 35642697 (View on PubMed)

Other Identifiers

REC/RCR/AHS/24/Ali Raza

Identifier Type: -

Identifier Source: org_study_id