Upper Extremity Strengthening Interventions in Children With UCP

NCT ID: NCT07116798

Last Updated: 2025-08-12

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 14 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-01
• Study Completion Date: 2026-07-07

Brief Summary

This study aims to compare the effects of two different upper extremity strengthening exercise approaches-bilateral strengthening exercises based on Proprioceptive Neuromuscular Facilitation (PNF) patterns and plyometric exercises-on muscle thickness, joint range of motion, muscle strength, and functional performance in children with unilateral spastic cerebral palsy (USCP). Although strengthening exercises targeting the affected upper limb in children with USCP have been investigated in numerous studies, to our knowledge, no previous research has directly compared the effects of bilateral PNF-based strengthening exercises and plyometric training. Incorporating PNF patterns into upper extremity rehabilitation programs has been previously recommended, and examining the efficacy of these exercises in comparison with plyometric training may contribute valuable insights to the literature and inform clinical practice.

Conditions

Cerebral Palsy (CP)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: QUADRUPLE

Study Groups

PNF Group (Strengthening Based on Proprioceptive Neuromuscular Facilitation Patterns)

The shoulder and scapular patterns listed below will first be taught to the child using the rhythmic initiation technique. Following instruction, the child will be asked to perform the patterns actively without resistance.

Shoulder flexion - adduction - external rotation and shoulder extension - abduction - internal rotation (with the elbow extended) Shoulder extension - adduction - internal rotation and shoulder flexion - abduction - external rotation (with the elbow extended) In addition to the shoulder patterns, scapular patterns including anterior depression - posterior elevation and anterior elevation - posterior depression will also be performed with the same progression.

Group Type: EXPERIMENTAL

Exercise

Intervention Type: OTHER

Strengthening Exercises Based on Proprioceptive Neuromuscular Facilitation Patterns

Plyometric Group (Plyometric Exercises)

Participants in the plyometric group will perform upper extremity plyometric exercises aimed at improving muscular power, neuromuscular control, and functional performance. The exercises will be selected to provide dynamic resistance and emphasize rapid stretch-shortening cycle movements of the upper limb. Training will be conducted using elastic bands, medicine balls, and body weight as appropriate to the child's developmental level and physical capacity. The exercise program will include progressive variations in terms of intensity, volume (sets and repetitions), and complexity over the intervention period, as detailed in the progression table. Rest intervals of no more than one minute will be allowed between sets. All exercises will be performed bilaterally and under the supervision of a physiotherapist to ensure proper technique and safety.

Group Type: EXPERIMENTAL

Exercise

Intervention Type: OTHER

Plyometric Exercises

Interventions

Exercise

Strengthening Exercises Based on Proprioceptive Neuromuscular Facilitation Patterns

Intervention Type: OTHER

Exercise

Plyometric Exercises

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Aged between 5 and 12 years
• Diagnosed with unilateral spastic type cerebral palsy
• Classified as Level I or II according to the Gross Motor Function Classification System (GMFCS)
• Classified as Level I or II according to the Manual Ability Classification System (MACS)
• Upper extremity muscle tone ≤2 on the Modified Ashworth Scale
• Willing to suspend other upper extremity therapeutic interventions during the study period
• Able to cooperate and follow instructions provided by the researcher
• Voluntarily willing to participate in the study

Exclusion Criteria

• History of any upper extremity surgery or Botulinum toxin (Btx) injection within the past 6 months
• Presence of an additional neurological disorder other than cerebral palsy
• Having visual and/or hearing impairments
• Having severe contractures that limit participation in functional activities

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 12 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Biruni University

OTHER

Sponsor Role: lead

Responsible Party

Gülsena Utku Umut

Assisstant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Biruni University

Istanbul, ZEYTİNBURNU, Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

Gülsena Utku Umut, PhD

Role: CONTACT

gumut@biruni.edu.tr

+90444 8 276

Facility Contacts

Gülsena Utku Umut, PhD

Role: primary

gumut@biruni.edu.tr

+904448276

References

Adiguzel H, Kirmaci ZIK, Gogremis M, Kirmaci YS, Dilber C, Berktas DT. The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial. Early Hum Dev. 2024 May;192:106010. doi: 10.1016/j.earlhumdev.2024.106010. Epub 2024 Apr 15.

Reference Type: BACKGROUND

PMID: 38653163 (View on PubMed)

Abd-Elmonem AM, Ali HA, Saad-Eldien SS, El-Nabie WAA. Efficacy of plyometric exercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study. Physiother Res Int. 2024 Jan;29(1):e2061. doi: 10.1002/pri.2061. Epub 2023 Nov 3.

Reference Type: BACKGROUND

PMID: 37922449 (View on PubMed)

Other Identifiers

FTR-UCP-001

Identifier Type: -

Identifier Source: org_study_id