Post Facilitation Stretch, Post Isometric Relaxation and Myofascial Release in Spastic Cerebral Palsy.

NCT06686719 | Recruiting

• 1 other identifier: Riphah/RCRAHS/REC/MS-PT/01942
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the study is to compare the effect of Post Facilitation Stretch, Post Isometric Relaxation and Myofascial Release on Lower Limb Spasticity in Spastic Cerebral Palsy. A randomized control trial was conducted at PAF School for PSN NUR KHAN Rawalpindi. The sample size was 30 calculated through G-Power tool. The participants were divided into three interventional groups each having 10 participants. The study duration was six months. Sampling technique applied was Convenient sampling for recruitment and group randomization using lottery method. Only 8 to 18 years Spastic Dipelgic CP children with Modified Asworth Scale having score 1, 1+ and 2 were included in the study. Tools used in this study are Goniometer, Modified Ashworth Scale, Active knee extension test, Weight bearing lunge test. Data was collected before and immediately after the application of interventions. Data analyzed through SPSS version 26.

Conditions

Spastic Diplegia Cerebral Palsy

Keywords

Spastic Cerebral Palsy; Myofascial; Spasticity

Outcome Measures

Primary Outcomes (2)

• Modified Ashworth Scale

  Changes from the baseline spasticity measured with help of modified ashworth scale

  Four Weeks

• Range of motion

  Changes from baseline range of motion of hip, knee and ankle will be measured with help of goniometer.

  Four Weeks

Secondary Outcomes (2)

• Active Knee Extension Test

  Four Weeks

• Weight Bearing Lunge Test

  Four Weeks

Study Arms (3)

Post Facilitation group

EXPERIMENTAL

subjects are asked to isometrically contract the hamstring and calf using 30 % of the strength for 15 seconds by attempting to push the leg back toward the therapist and relax. The therapist then passively stretched the muscle until a mild stretch sensation was reported. The stretch was held for another 10 seconds. This sequence will repeat 5 times on each subject in the group. Stretching of the hip flexors, adductors and plantarflexor muscles. Functional training includes bridging, kneeling, sit to stand

Other: Post Facilitation

Post Isometric Relaxation

ACTIVE COMPARATOR

Subjects are asked to isometrically contract the hamstring and calf using 25 % of the strength for 7-10 seconds by attempting to push the leg back toward the therapist and relax. After relaxation, the therapist further extends the knee for 3 to 5 seconds. This sequence will repeat 5 times on each subject in the group. Stretching of the hip flexors, adductors and plantarflexor muscles. Functional training includes bridging, kneeling, sit to stand.

Other: Post Isometric Relaxation

Myofascial Release

ACTIVE COMPARATOR

MFR for Hamstring muscle will be given with patient in prone position with 120 second hold. For giving the MFR, the thumb of the therapist will be allowed to sink in to the central portion of the hamstring. It will held for 120 seconds to allow the tissue to soften and then myofascial structures will spread in a lateral direction until feeling of first fascial barrier. MFR will be performed for 15 mins.

Other: Myofascial Release

Interventions

Post Facilitation OTHER

For hamstring muscle, the patient positioned in supine with hip and knee flexed to mid- range. For calf muscle, the patient positioned in supine with straight leg. Now therapist ask the subjects to isometrically contract the hamstring and calf using 30 % of the strength for 15 seconds by attempting to push the leg back toward the therapist and relax. The therapist then passively stretched the muscle until a mild stretch sensation was reported. The stretch was held for another 10 seconds. This sequence will repeat 5 times on each subject in the group. Stretching of the hip flexors, adductors and plantar flexors. Functional training includes bridging, kneeling and sit to stand.

Post Facilitation group

Post Isometric Relaxation OTHER

For hamstring muscle, the patient positioned in supine with hip and knee flexed. For calf muscle, the patient positioned in supine with straight leg. Now therapist ask the subjects to isometrically contract the hamstring and calf using 25 % of the strength for 7-10 seconds by attempting to push the leg back toward the therapist and relax.After relaxation, the therapist further extends the knee for 3 to 5 seconds.. This sequence will repeat 5 times on each subject in the group. Stretching of the hip flexors, adductors and plantar flexors. Functional training includes bridging, kneeling and sit to stand.

Post Isometric Relaxation

Myofascial Release OTHER

MFR for Hamstring muscle will be given with patient in prone position with 120 second hold. For giving the MFR, the thumb of the therapist will be allowed to sink in to the central portion of the hamstring. It will held for 120 seconds to allow the tissue to soften and then myofascial structures will spread in a lateral direction until feeling of first fascial barrier. MFR will be performed for 15 mins. Stretching of the hip adductors, hip flexors and plantar flexors. Functional training includes kneeling, bridging and sit to stand.

Myofascial Release

Eligibility Criteria

• Age: 8 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Spasticity score of less than 3 on MAS
• Known cases of Spastic diplegic cerebral palsy.
• Children who follow commands.

You may not qualify if:

• Epilepsy history
• hip or spinal deformities
• Severe contractures, joint dislocations
• Discrepancy in leg length
• Recent orthopedic surgery
• Children with cognitive impairment.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

PAF School For PSN NUR KHAN

Rawalpindi, Pakistan

RECRUITING

MeSH Terms

Conditions

Cerebral palsy, spastic, diplegic; Cerebral Palsy; Muscle Spasticity

Interventions

Myofascial Release Therapy

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Muscular Diseases; Musculoskeletal Diseases; Muscle Hypertonia; Neuromuscular Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Officials

• Ammanullah Nazir, PHD*

  Riphah International University Islamabad

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PHD

CONTACT

+923324390125; imran.amjad@riphah.edu.pk

Muhammad Arslan Malik, MS*

CONTACT

+923335757407; arslan967m@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 12, 2024
• First Posted: November 13, 2024
• Study Start: May 3, 2024
• Primary Completion: December 3, 2024
• Study Completion: December 13, 2024
• Last Updated: November 13, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)