Aquatic Based Exercises Versus Mirror Therapy on Hand Dexterity and Strength in Hemiplegic Child

NCT07072416 | Active Not Recruiting

• 1 other identifier: P.T.REC/012/005354
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

Cerebral palsy (CP) is a neurologic disorder that affects motor function, balance, and posture, and spastic hemiplegia is found in about one-third of persons with CP and often leads to devastating upper limb disability. Rehabilitation interventions such as aquatic therapy and mirror therapy are commonly utilized to improve motor function and functional independence. Water therapy takes advantage of water resistance and buoyancy to relax tightened muscles, promote gross motor function, and increase muscle endurance and strength with studies showing significant improvements in motor skills as well as a reduction in spasticity in CP children, especially hemiplegic children. Water therapy can also be more enjoyable and convenient for kids, but safety has to be considered. Mirror therapy does utilize visual feedback, but to cause the movement in the paralyzed limb, and can increase hand dexterity and grip strength by stimulating the neural pathways through the illusion of movement. Although aquatic therapy has shown well-defined advantages in motor functioning and muscle tone, comparison of the efficacy of aquatic exercises and mirror therapy for hand dexterity and grip strength in hemiplegic CP has been limited, and further studies are indicated to establish their relative merits and potential complementary uses.

Conditions

Cerebral Palsy (CP); Hemiplegia and Hemiparesis

Keywords

Aquatic Based Exercises; Hemiplegic Child; Hand Dexterity; Mirror Therapy; Hand Strenght; Cerebral Palsy

Outcome Measures

Primary Outcomes (2)

• Box and Block Test: It was used to assess gross manual dexterity

  The Box and Block Test (BBT) is a widely used test to evaluate gross manual dexterity by rehabilitation centers and occupational therapy clinics. The individual has to move as many blocks as possible from one of the compartments of a box to the other in a given time period, usually one minute, using one hand at a time. The BBT is valued for simplicity, ease of use, and strong reliability and validity across the lifespan, and in clinical populations like children, adults, and those with neurological or musculoskeletal disorder

  3 Months

• Hand held dynamometer to assess hand grip strength.

  A popular, trustworthy, and legitimate tool for evaluating hand grip strength-a crucial sign of general muscle function and health-is a hand-held dynamometer.

  3 Months

Study Arms (3)

Group 1: Aquatic Therapy

EXPERIMENTAL

Children in Group A will receive aquatic based exercises and a designed physical therapy program

Other: Aquatic Exercise; Other: Designed physical therapy program.

Group 2: Mirror Therapy

EXPERIMENTAL

Group B will receive mirror therapy and a designed physical therapy program

Other: Mirror Therapy; Other: Designed physical therapy program.

Group 3: Control Group

OTHER

Control Group (C) will receive a designed physical therapy program.

Other: Designed physical therapy program.

Interventions

Aquatic Exercise OTHER

Aquatic exercise or hydrotherapy, involving the performance of physical exercise in water, has been determined to have an assortment of beneficial health impacts on healthy individuals and those with chronic diseases. Aquatic exercise has been determined to enhance strength, balance, flexibility, and the quality of life, particularly among groups like postmenopausal women, patients with osteoarthritis, Parkinson's disease, and type 2 diabetes

Group 1: Aquatic Therapy

Mirror Therapy OTHER

Mirror therapy is a type of rehabilitation where visual feedback is employed to induce movement and recovery in an affected limb by asking the patients to observe the reflection of their healthy limb in a mirror, giving the illusion that both limbs are moving normally.

Group 2: Mirror Therapy

Designed physical therapy program. OTHER

The program will start with 10 minutes of poolside exercises including warming up, active range of motion and stretching followed by 20 minutes of aquatic exercise in the pool. The pool session consists of 20 minutes of active range of motion, stretching and strengthening exercises

Group 1: Aquatic Therapy; Group 2: Mirror Therapy; Group 3: Control Group

Eligibility Criteria

• Age: 6 Years - 12 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children with Hemiplegic cerebral palsy
• Children with mild to moderate spasticity of wrist muscles spasticity will range between (0-4) score according to Modified Ashworth Scale.
• Children will be able to follow the instructions.
• Children without any genetic disorders.

You may not qualify if:

• Cognitive impairment.
• Unilateral neglect disorders.
• Orthopedic dysfunction.
• Visual impairment.
• Verbal impairment.
• Open wound or infection
• Fixed contractures.
• Previous limb surgeries within 6 months.
• Resting angina.

Sponsors & Collaborators

• Alaa Noureldeen Kora: lead

Study Sites (1)

Damanhur Medical National Institute Hospital

Damanhur, Beheira, 5844152, Egypt

Location

Related Publications (6)

• Adar S, Dundar U, Demirdal US, Ulasli AM, Toktas H, Solak O. The effect of aquatic exercise on spasticity, quality of life, and motor function in cerebral palsy. Turk J Phys Med Rehabil. 2017 Aug 14;63(3):239-248. doi: 10.5606/tftrd.2017.280. eCollection 2017 Jun.

  PMID: 31453460 BACKGROUND

• Roostaei M, Baharlouei H, Azadi H, Fragala-Pinkham MA. Effects of Aquatic Intervention on Gross Motor Skills in Children with Cerebral Palsy: A Systematic Review. Phys Occup Ther Pediatr. 2017 Oct 20;37(5):496-515. doi: 10.1080/01942638.2016.1247938. Epub 2016 Dec 14.

  PMID: 27967298 BACKGROUND

• El-Shamy SM. Effects of Antigravity Treadmill Training on Gait, Balance, and Fall Risk in Children With Diplegic Cerebral Palsy. Am J Phys Med Rehabil. 2017 Nov;96(11):809-815. doi: 10.1097/PHM.0000000000000752.

  PMID: 28410250 BACKGROUND

• Lai CJ, Liu WY, Yang TF, Chen CL, Wu CY, Chan RC. Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. J Child Neurol. 2015 Feb;30(2):200-8. doi: 10.1177/0883073814535491. Epub 2014 Jun 5.

  PMID: 24907137 BACKGROUND

• Ryu K, Ali A, Kwon M, Lee C, Kim Y, Lee G, Kim J. Effects of assisted aquatic movement and horseback riding therapies on emotion and brain activation in patients with cerebral palsy. J Phys Ther Sci. 2016 Dec;28(12):3283-3287. doi: 10.1589/jpts.28.3283. Epub 2016 Dec 27.

  PMID: 28174435 BACKGROUND

• Stavsky M, Mor O, Mastrolia SA, Greenbaum S, Than NG, Erez O. Cerebral Palsy-Trends in Epidemiology and Recent Development in Prenatal Mechanisms of Disease, Treatment, and Prevention. Front Pediatr. 2017 Feb 13;5:21. doi: 10.3389/fped.2017.00021. eCollection 2017.

  PMID: 28243583 BACKGROUND

MeSH Terms

Conditions

Cerebral Palsy; Hemiplegia; Paresis

Interventions

Aquatic Therapy; Mirror Movement Therapy

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Hydrotherapy; Physical Therapy Modalities; Therapeutics; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Blinding to the assessor
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Randomized Controlled Trial

Study Record Dates

• First Submitted: July 9, 2025
• First Posted: July 18, 2025
• Study Start: May 1, 2025
• Primary Completion: August 30, 2025
• Study Completion: September 30, 2025
• Last Updated: July 22, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)