Carry-Over Effects of Lower Limb Cross-Training Priming on Upper Limb Function in Children With Unilateral Cerebral Palsy

NCT07525752 | Completed DMC

• 1 other identifier: P.T.REC/012/006149
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

PURPOSE: The purpose of this randomized controlled trial was to investigate the potential carry-over effects of a 6-week lower limb strengthening-based cross-training (CT) priming protocol, added to standard physical rehabilitation, on affected upper limb function in children aged 6-8 years with unilateral cerebral palsy (UCP), compared to standard physical rehabilitation alone. BACKGROUND: Children with unilateral cerebral palsy (UCP) experience motor impairments affecting both lower and upper limbs, significantly impacting functional independence. While rehabilitation often targets specific limbs, interventions may induce broader neuroplastic changes. Movement-based priming, particularly strengthening-based cross-training (CT) targeting the less-affected limb, has shown promise for improving contralateral lower limb function in UCP, likely via cross-education mechanisms involving central nervous system adaptations. However, it remains largely unexplored whether such lower limb-focused priming interventions can induce secondary "carry-over" effects, positively influencing the function of the ipsilaterally affected upper limb through potential mechanisms like widespread neural adaptations or improved postural stability. Addressing this gap is crucial for understanding the holistic impact of priming interventions and optimizing rehabilitation strategies. HYPOTHESES: There will be no statistically significant difference in the improvement of affected handgrip strength, grasping skills and functional UL Outcome Measure between children receiving lower limb CT priming plus standard rehabilitation and those receiving standard rehabilitation alone over the 6-week intervention period. RESEARCH QUESTION: Does the addition of a 6-week lower limb strengthening-based cross-training priming protocol to standard physical rehabilitation result in significantly greater improvements in affected upper limb function (specifically handgrip strength and grasping skills) compared to standard physical rehabilitation alone in children aged 6-8 years with unilateral cerebral palsy?

Conditions

Cerebral Palsy (CP); Unilateral Cerebral Palsy

Outcome Measures

Primary Outcomes (1)

• Handgrip Strength (HGS)

  Handgrip strength measured by Jamar hand dynamometer

  Baseline and after 6 weeks of training

Secondary Outcomes (1)

• Peabody Developmental Motor Scales-2, Fine Motor subtest (PDMS-2 FM) - Grasping Age Equivalent

  Baseline and after 6 weeks of training

Study Arms (2)

Standard Rehabilitation Only

ACTIVE COMPARATOR

Children receive 60 minutes of standard physical rehabilitation targeting motor function, 3 sessions per week for 6 weeks, with no lower limb cross-training priming.

Other: Standard rehabilitation program

Lower Limb Cross-Training Priming + Standard Rehabilitation

EXPERIMENTAL

Children receive 10-15 minutes of lower limb strengthening-based cross-training priming of the less-affected limb, immediately followed by the same 60-minute standard rehabilitation program, 3 sessions per week for 6 weeks.

Other: Standard rehabilitation program; Other: Lower Limb Cross-Training Priming

Interventions

Standard rehabilitation program OTHER

60-minute physical therapy program including strengthening, balance, and functional activities for children with unilateral cerebral palsy.

Lower Limb Cross-Training Priming + Standard Rehabilitation; Standard Rehabilitation Only

Lower Limb Cross-Training Priming OTHER

10-15 minutes of lower limb strengthening-based cross-training of the less-affected limb used as movement-based priming prior to standard rehabilitation.

Lower Limb Cross-Training Priming + Standard Rehabilitation

Eligibility Criteria

• Age: 6 Years - 8 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Mild spasticity (MAS 1 or 1+), independent ambulation (AFOs permitted), and the ability to follow simple instructions.

You may not qualify if:

• Children with significant fixed deformities, cognitive or sensory impairments hindering participation, uncontrolled epilepsy, or recent interventions like botulinum toxin or orthopedic surgery.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Cairo University

Giza, Cairo Governorate, 12613, Egypt

Location

Related Publications (2)

• Kumari R, Dybus A, Purcell M, Vuckovic A. Motor priming to enhance the effect of physical therapy in people with spinal cord injury. J Spinal Cord Med. 2025 Mar;48(2):312-326. doi: 10.1080/10790268.2024.2317011. Epub 2024 Feb 23.

  PMID: 38391261 BACKGROUND

• Stoykov ME, Madhavan S. Motor priming in neurorehabilitation. J Neurol Phys Ther. 2015 Jan;39(1):33-42. doi: 10.1097/NPT.0000000000000065.

  PMID: 25415551 BACKGROUND

MeSH Terms

Conditions

Cerebral Palsy

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

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: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: March 31, 2026
• First Posted: April 13, 2026
• Study Start: January 1, 2026
• Primary Completion: March 30, 2026
• Study Completion: March 31, 2026
• Last Updated: April 13, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)