Purpose of the study: To evaluate the effect of closed kinetic chain on hip stability after selective dorsal rhizotomy on spastic cerebral palsy.
* This is a prospective randomized controlled clinical trial, conducted at Kafr El sheikh Hospital. * Sixty-six children of both genders. * The study will include children (age 5-14years) post selective dorsal rhizotomy. * Children meeting the inclusion criteria will be randomly assigned to one of two groups: * Experimental Group: children in this group will receive closed kinetic chain. * Control Group: Patients in this group will receive Traditional physical therapy. * Randomization will be achieved using computer-generated random numbers to ensure an equal distribution of patients between the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
66
●Close kinetic chain exercise group: group A will receive forward step-ups, lateral step-ups, squats, sit-to-stand, and stoop-and-recover exercises. session will be initiated with a 10 min warm-up period, including stretching of the major muscles and muscle groups, then 40 min different exercises and terminated with a 10 min cool-down period in the form of aerobic exercises.
●Traditional physiotherapy: group B will receive stretching for the lower extremity muscles, namely hip flexors and adductors, hamstrings, and calf muscles; and strengthening exercises for core muscles, hip extensors, flexors and abductors, internal and external rotators of the hip, flexors and extensors of the knee, ankle dorsi flexors, kneeling exercises, and standing and gait training
Faculty of physical therapy, Kafr elsheikh University
Kafr ash Shaykh, Kafr Elsheikh, Egypt
Isokinetic dynamometry:
Isokinetic dynamometry testing is a device used within sports and exercise science as well as clinical testing environments that is used to evaluate joint torque. Isokinetic dynamometers are able to test the strength (torque) and power of different muscle groups. is a safe and reliable method accepted as the "gold standard" in the evaluation of muscle strength. It will be used before and after intervention to measure muscle strength
Time frame: 12 weeks
X-ray:
used to assess the alignment of the hip joint, detect any abnormalities, and determine the degree of bone deformities or hip dislocation. Will be used before and after intervention to determine hip angles
Time frame: 12 weeks
The Pediatric Balance Scale:
The Pediatric Balance Scale (PBS), which is a modification of Berg Balance Scale (BBS) designed for children and adolescents aged 5 to 15 years, to assess functional balance abilities. The scale is composed of 14 items that are scored on a criterion-based 0 to 4 scale. The range of scores in the PBS is 0 to 56. each activity is rated on a five-point scale (0-4) so that the maximum score is 56. Patients who score 41 or higher are considered to be a low fall risk, those who score between 21 and 40 are considered to be moderate fall risks, and those who score below 20 are considered to be high fall risks. It will be completed in 15-20 minutes
Time frame: 12 weeks
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