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Movement-Based Priming: A Clinical Trial on the Effect of Cross-Training on Locomotor Abilities of Children with
Tamer M Elsaeed1,2, Ragab K Elnaggar3,4, Mohammed F Elbanna2,4
1Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12611, Egypt.
Insights
Cross-training with unilateral priming significantly improved muscle strength, joint mobility, and locomotor abilities in children with unilateral cerebral palsy (UCP). This approach offers a promising enhancement to existing rehabilitation programs for UCP.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Disorders
- Movement Science
Background:
- Children with unilateral cerebral palsy (UCP) often face challenges with walking and movement due to muscle weakness and limited joint mobility.
- Movement-based interventions like cross-training (CT) are being explored to improve motor function in UCP, but evidence is still developing.
- Unilateral priming, a specific type of CT, targets the less-affected limb to potentially enhance overall motor function.
Purpose of the Study:
- To evaluate the impact of a strengthening-based unilateral priming cross-training (CT) protocol on muscle strength, joint mobility, and locomotor function in children with UCP.
- To compare the effectiveness of this specialized CT program against a standard rehabilitation program.
Main Methods:
- A randomized controlled trial involving 36 children with UCP.
- Participants were assigned to either a control group (standard rehabilitation) or a CT group (unilateral priming exercises followed by standard rehabilitation).
- Key metrics assessed included dorsiflexor strength, ankle joint mobility, and various measures of locomotor ability (10mWT, 6MWT, TUG) before and after the intervention.
Main Results:
- The CT group showed statistically significant and clinically meaningful improvements in dorsiflexor strength, ankle mobility, and all assessed locomotor abilities compared to the control group.
- Effect sizes for the improvements in the CT group ranged from moderate to large across all outcome measures.
- Specific improvements were noted in the 10m walk test, 6-minute walk test, and timed up-and-go test.
Conclusions:
- Strengthening-based unilateral priming cross-training (CT) is an effective intervention for improving motor function in children with UCP.
- This specialized CT protocol demonstrates potential as a valuable addition to conventional physical rehabilitation strategies for pediatric UCP.
- Further research can explore long-term effects and optimal implementation of this intervention.
Abstract:
Background: Children with unilateral cerebral palsy (UCP) frequently experience limitations in locomotor abilities, attributable to a complex interplay of factors including muscle weakness and reduced joint mobility. Movement-based priming, such as cross-training (CT), has emerged as a potential intervention to enhance motor function in children with UCP. However, evidence of its efficacy remains limited. Objective: This study aimed to investigate the effect of CT-specifically, a strengthening-based unilateral priming protocol-on muscle strength, joint mobility, and locomotor abilities in children with UCP. Methods: Thirty-six children with UCP were enrolled in a randomized controlled trial. Participants were randomized into two groups: the control group (n = 18; underwent a tailored physical rehabilitation program) and the CT group (n = 18; participated in a CT program incorporating unilateral priming exercises targeting the less-affected lower followed by the same rehabilitation program administered to the control group). Dorsiflexor strength, ankle joint mobility, and locomotor ability assessed via the 10 m walk test (10 mWT), 6 min walk test (6 MWT), and timed up-and-go test (TUG) were evaluated pre- and post-intervention. Results: Significant moderate-to-large between-group differences were observed in dorsiflexor strength (p = 0.032, partial η2 = 0.128), ankle mobility (p = 0.016, partial η2 = 0.159), and locomotor ability (10 mWT [p = 0.017, partial η2 = 0.157]; 6 MWT [p = 0.004, partial η2 = 0.222]; TUG [p = 0.047, partial η2 = 0.111]). The CT group demonstrated superior improvements concerning all outcomes. Conclusions: Unilateral priming through strengthening-based CT is a viable intervention for enhancing motor function in children with UCP, providing a promising complement to the current rehabilitation protocols.
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