The study design will be a Randomized control trial. The data will be collected from Acme Medical complex and Rehab cure clinic. The study will be completed in 10 months after the approval of synopsis. The sampling technique will be non-probability convenient sampling. Sample size is 16 calculated by epitool. Group A will receive Routine Physical therapy with play based neural mobilization activity method and Group B will receive Routine Physical therapy with baseline treatment. Diplegic cerebral palsy girls and boys included with age limit 6-12 years and without history of injury 1 year, Patients who cannot obey commands will be excluded. Hand dynamometer and pegboard test will used as outcome tool. Single blinding will be used. Data Analysis will be done on Statistical Package for the Social Sciences (SPSS) version 23.00.
Examining the UL's hand grip strength is arguably the best method to determine its overall consistency. Everybody's everyday life depends on their upper limbs. For people to function at their best, a number of sensorimotor factors are required, including hand grip strength. Dexterity is a manual skill that requires quick synchronization of voluntary gross and fine movements. It is built on a number of abilities that are developed via education, practice, and experience. It is commonly known as the "ability to use the hand in daily activities based on the anatomical integrity, sensation, coordination, strength, and dexterity." Both manual dexterity and grip strength are necessary for work-related tasks as well as play, leisure, and self-care activities. Neural mobilization (NM), a treatment approach used to treat patients with musculoskeletal disorders, has demonstrated promise in lowering pain and enhancing functionality. Combinations of joint motions that facilitate the gliding or tensioning of neural tissue make up NM, which can be carried out actively by the patient or passively by the healthcare provider. It is thought to promote axoplasmic flow, neural vascularity, and nerve gliding in relation to surrounding tissues, all of which lead to better neural functioning and, ultimately, better motor and sensory performance. The aim of study is to determine the effects of play based neural mobilization activities on hand grip strength and dexterity in cerebral palsy. The study design will be a Randomized control trial. The data will be collected from Acme Medical complex and Rehab cure clinic. The study will be completed in 10 months after the approval of synopsis. The sampling technique will be non-probability convenient sampling. Sample size is 16 calculated by epitool. Group A will receive Routine Physical therapy with play based neural mobilization activity method and Group B will receive Routine Physical therapy with baseline treatment. Diplegic cerebral palsy girls and boys included with age limit 6-12 years and without history of injury 1 year, Patients who cannot obey commands will be excluded. Hand dynamometer and pegboard test will used as outcome tool. Single blinding will be used. Data Analysis will be done on Statistical Package for the Social Sciences (SPSS) version 23.00.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
34
treatment include muscle stretching, strengthening, gait training, Range of motion exercises for both upper and lower limbs. Group A will perform neural mobilization which include ulnar, median and radial nerves mobilisation by a play activity called "Simon says" in addition to the routine physical therapy treatment. Total 20 sessions will be performed (40 min, 3 days a week)
Regular physical therapy was administered to the control group along with baseline care. These workouts included upper and lower limb range of motion activities, gait training, strengthening exercises, and stretching exercises.
Acme Medical center, Liaqat medical center
Lahore, Punjab Province, Pakistan
RECRUITINGHand Dynamometer for hand grip strength
Handgrip dynamometers are employed for a wide range of purposes. Assessing general strength is the most widely used method for comparing muscular function across groups, evaluating the course of wasting disorders such as sarcopenia, and even identifying prospective deficits. In order to quantify the strength of various muscles that are directly linked to a pathological condition, such as rotator cuff strength, handgrip dynamometers are also utilized as functional evaluation instruments. Handgrip dynamometers are mostly used for evaluation in the rehabilitation process, such as monitoring general rehabilitation progress or assessing the impact of a particular rehabilitation regimen aimed at a grip strength issue, such as shoulder impingement syndrome. Strong handgrips are essential for independent and fulfilling daily functioning
Time frame: baseline, 16th weeks
Pegboard test for Dexterity
The functional dexterity test (FDT), a timed pegboard test that involves manipulating each peg, is appropriate for young children due to its ease of use and speed. The 16-hole wooden pegboard used for the FDT is set up in four rows of four, with each peg hole that is 2.5 cm in diameter, 3 cm deep, and 2 cm away from the neighboring peg holes. Every patient will be requested to take a seat in a chair facing the FDT pegboard on a table. The patients will be instructed to practice by flipping every peg on the board once. After the test will be completed, the examiner will note how long it take to complete the test
Time frame: baseline, 16th week
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