Effect of a structured aqua-plyometric exercise program on postural control and functional ability in children with hemiparetic cerebral palsy: A two-arm randomized controlled trial

Abstract

BACKGROUND: Individuals with hemiparetic cerebral palsy (h-CP) encounter postural control issues that largely interfere with activity and participation. So, there might be a need for improved, clearly effective rehabilitation protocols that target postural control dysfunction, which may, then, reduce activity limitations and participation restrictions. OBJECTIVE: This trial was undertaken to examine the effect of a structured, 12-week aqua-plyometric (Aqua-PLYO) exercise program on postural control and functional ability in children with h-CP. METHODS: Fifty-six children with h-CP took part in a two-arm, randomized single-blind controlled trial. They were randomly assigned to either receive the standard physical therapy (Control group; n = 28) or the Aqua-PLYO training program (Aqua-PLYO group; n = 28), three times/week over 12 consecutive weeks. The dynamic limit of stability [i.e., movement directional control (M-DC), reaction time (ReT), movement velocity (M-Vel), endpoint excursion (EP-Exc), and maximum excursion (M-Exc)] and functional ability [i.e., 30-second sit-to-stand test (30sec-STS), timed up and down stairs test (TUDS), and the dynamic gait index (DGI)] were assessed pre- and post-treatment. RESULTS: From the pre- to post-treatment occasion, the Aqua-PLYO group achieved greater improvement for the M-DC (P = 0.013), ReT (P = 0.004), M-Vel (P = 0.03), EP-Exc (P = 0.002), and M-Exc (P = 0.006), compared to controls. Besides, the Aqua-PLYO group showed more conducive changes in functional ability [as evidenced by the 30sec-STS (P = 0.005), TUDS (P = 0.002), and DGI (P = 0.004) scores]. CONCLUSION: Aqua-PLYO training is likely an effective training paradigm for enhancing postural control and functional ability in children with h-CP. Further studies are, however, recommended to substantiate the current evidence.

The Impact of Open and Closed Kinetic Chain Exercises in Water on Pain and LumboPelvic Stability Men with Non-Special Chronic Back Pain

“…Studies show that almost 80% of adults experience at least one episode of back pain in their lifetime, and water rehabilitation is one of the most successful ways to reduce chronic back pain (1,2,3,4). Although exercises are common in low back pain rehabilitation, there is little agreement on how to use the components of each of the open and closed kinetic chain of motion exercises (34). One reason for the discrepancy is whether weight bearing should be an inherent component of therapeutic activities (35).…”

Paretic-Limb-Only Plyometric Training Outperforms Volume-Matched Double-Limb Training for Ameliorating Balance Capability and Gait Symmetry in Adolescents with Unilateral Cerebral Palsy: A Comparative Study

“…Third, the research team hypothesized that increasing the dose and frequency of training might cause undue fatigue, thereby, negatively affecting performance and adherence to the training. After all, available evidence on the role of Plyo training in individuals with U-CP demonstrated that 8–12 weeks of training were enough to yield significant changes in several aspects of motor function such as muscle strength, postural control, weight-bearing symmetry, temporal/spatial gait symmetry, response-capacity to balance threats, and functional ability [ 3 , 14 , 15 , 16 , 17 , 18 ].…”

“…From this perspective, Plyo training has recently been suggested for the augmentation of motor function in adolescents with U-CP. Prior studies have evidenced that Plyo training can safely and effectively be used for augmenting gross motor function, increasing muscle strength, promoting symmetrical weight-bearing, boosting postural control, and reducing temporo-spatial asymmetrical gait patterns in adolescents with U-CP [ 3 , 14 , 15 , 16 , 17 , 18 ].…”

“…Despite the significance of the findings from prior studies [ 3 , 14 , 15 , 16 , 17 , 18 ], they have investigated the effectiveness of programs employing either the double-limb Plyo training (DLPT) alone or combined with other exercise approaches, while no studies have specifically been undertaken to compare the effect of the paretic-limb-only Plyo training (PLPT) versus the DLPT in individuals with U-CP. It has been demonstrated that, during explosive motor tasks, force production when muscles of both limbs act simultaneously tends to be lower than the sum of total force produced by each limb acting separately [ 19 ].…”

The Effect of Neuro-Physiotherapy on Gross Motor Function in a Male Child With Spastic Diplegic Cerebral Palsy: A Case Report

“…The therapist should additionally promote greater trunk and pelvic mobility as well as active trunk extension which may result in better balance and posture [5]. Aquatherapy, which involves alternating movements of the lower extremities, and therapeutic riding on horses are additional beneficial treatments [6].…”