Elnaggar Ragab K, Ramirez-Campillo Rodrigo, Azab Alshimaa R, Alrawaili Saud M, Alghadier Mshari, Alotaibi Mazyad A, Alhowimel Ahmed S, Abdrabo Mohamed S, Elbanna Mohammed F, Aboeleneen Ahmed M, Morsy Walaa E
Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt.
Children (Basel). 2024 Feb 15;11(2):243. doi: 10.3390/children11020243.
The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12-18 years) were randomized to PsCS ( = 27), PlyoML ( = 27), or a combined intervention ( = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability-LoS), balance, and mobility (Community Balance and Mobility Scale-CB&M; Functional Walking Test-FWT; Timed Up and Down Stair test-TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward ( = 0.006 and 0.033, respectively), forward ( = 0.015 and 0.036, respectively), paretic ( = 0.017 and 0.018, respectively), and non-paretic directions ( = 0.006 and 0.004, respectively)], and this was also the case for overall LoS ( < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M ( = 0.037 and = 0.002, respectively), FWT ( = 0.012 and = 0.038, respectively), and TUDS ( = 0.046 and = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP.
脑瘫患儿综合治疗方法的模式已得到广泛认可，促使临床医生在独立治疗和综合治疗之间进行权衡。然而，这一决策过程往往因缺乏可用于指导最佳治疗策略的实证证据而受阻。因此，本研究旨在比较基于普拉提的核心强化训练（PsCS）、基于增强式训练的肌肉负荷训练（PlyoML）及其组合对单侧脑瘫（ULCP）患儿姿势控制、平衡和运动能力的影响。81名ULCP患儿（年龄：12 - 18岁）被随机分为PsCS组（n = 27）、PlyoML组（n = 27）或联合干预组（n = 27；总组数/重复次数相等）。三种干预措施每周进行两次，连续进行12周。在干预前后评估姿势控制（稳定性极限-LoS的方向和总体情况）、平衡和运动能力（社区平衡与运动能力量表-CB&M；功能性步行测试-FWT；定时上下楼梯测试-TUDS）。与PsCS组和PlyoML组相比，联合组在LoS方向上的增加更大，包括向后方向（分别为p = 0.006和0.033）、向前方向（分别为p = 0.015和0.036）、患侧方向（分别为p = 0.017和0.018）和非患侧方向（分别为p = 0.006和0.004），总体LoS情况也是如此（与PsCS组和PlyoML组相比，p < 0.001）。此外，与PsCS组和PlyoML组相比，联合组在CB&M（分别为p = 0.037和p = 0.002）、FWT（分别为p = 0.012和p = 0.038）和TUDS（分别为p = 0.046和p = 0.021）方面有更大的改善。总之，与单模式训练相比，PsCS和PlyoML联合运动计划能使ULCP患儿在姿势控制、平衡和运动能力方面有更显著的改善。
