Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial

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

“…Several studies have highlighted the value of Plyo training for children/adolescents with U-CP [ 3 , 14 , 15 , 16 ]. Nevertheless, there have been no controlled studies that compared the effects of PLPT versus DLPT training among these patients.…”

“…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 ].…”

“…On a 4-week basis, the number of exercise sets/repetitions was gradually increased in three blocks, thereby, avoiding adaptation, reducing the risk of overload-induced injury/fatigue, and allowing for a new training stimulus. Exercises in the PLPT or DLPT paradigms were adopted from a series of studies on the effect of Plyo training in adolescents with CP [ 3 , 14 , 15 , 16 ]. A standardized 10 min warm-up and cooldown, including static/dynamic stretches, low-intense treadmill walking (at a speed that corresponds to 50–60% of the age-predicted heart rate maximum), and upper limb movements in combination with respiratory exercises were performed before and after the Plyo workout.…”

“…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 ].…”