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Elnaggar RK, Azab AR, Alhowimel AS, Alotaibi MA, Abdrabo MS, Elfakharany MS. Effects of Plyometric-Based Hydro-Kinesiotherapy on Pain, Muscle Strength, Postural Stability, and Functional Performance in Children with Hemophilic Knee Arthropathy: A Randomized Trial. Phys Occup Ther Pediatr 2024; 44:704-720. [PMID: 38463004 DOI: 10.1080/01942638.2024.2327363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
AIM To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA). METHODS Forty-eight children with HKA (age: 8-16 years) were randomly allocated to the Plyo-HKT group (n = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group (n = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 o/sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention. RESULTS In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain (p = .028, η2p = 0.10), peak torque of quadriceps [120°/sec (p = .007, η2P = 0.15); 180°/sec (p = .011, η2P = 0.13)] and hamstring [120°/sec (p = .024, η2P = 0.11); 180°/sec (p = .036, η2P = 0.09)], DLPSdirectional [forward (p = .007, η2P = 0.15); backward (p = .013, η2P = 0.12); affected side (p = .008, η2P = 0.14); non-affected side (p = .002, η2P = 0.20)], DLPSoverall (p < .001, η2P = 0.32), and functional performance [FISH (p < .001, η2p = 0.26); 6-MWT (p = .002, η2p = 0.19)]. CONCLUSION Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alshimaa R Azab
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmed S Alhowimel
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mazyad A Alotaibi
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohamed S Abdrabo
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Mahmoud S Elfakharany
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Elnaggar RK, Ramirez-Campillo R, Azab AR, Alrawaili SM, Alghadier M, Alotaibi MA, Alhowimel AS, Abdrabo MS, Elbanna MF, Aboeleneen AM, Morsy WE. Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics. CHILDREN (BASEL, SWITZERLAND) 2024; 11:243. [PMID: 38397355 PMCID: PMC10887404 DOI: 10.3390/children11020243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/30/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
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 (n = 27), PlyoML (n = 27), or a combined intervention (n = 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 (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M (p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 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.
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Affiliation(s)
- Ragab K. Elnaggar
- 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
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Alshimaa R. Azab
- 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
| | - Saud M. Alrawaili
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mshari Alghadier
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mazyad A. Alotaibi
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Ahmed S. Alhowimel
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohamed S. Abdrabo
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza 11432, Egypt
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Mohammed F. Elbanna
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed M. Aboeleneen
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza 11432, Egypt
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Walaa E. Morsy
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
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Elnaggar RK, Elfakharany MS. Aqua-Plyometric Exercises-Induced Changes in Muscle Strength, Bone Mineral Properties, and Physical Fitness in Patients With Juvenile Idiopathic Arthritis: A 12-Week, Randomized Controlled Trial. Pediatr Exerc Sci 2023; 35:198-205. [PMID: 36535274 DOI: 10.1123/pes.2022-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 10/08/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To determine whether a 12-week, lower body-targeted aqua-plyometric (AquaPlyo) exercise program could improve muscle strength, bone mineral properties, and physical fitness in patients with juvenile idiopathic arthritis. METHODS A randomized controlled trial was adopted and included 48 patients with polyarticular juvenile idiopathic arthritis (age: 12-18 y). Patients were assigned to undergo either AquaPlyo exercises (AquaPlyo group, n = 24) or standard exercises (control group, n = 24). The outcome measures were assessed pretreatment and posttreatment and included concentric quadriceps peak torque, bone mineral properties (areal bone mineral density [BMD], volumetric BMD, bone mineral content, and BMD Z score), and physical fitness. RESULTS A significant posttreatment increase in the concentric quadriceps peak torque was detected in the AquaPlyo group compared with the control group (either at an angular velocity of 90°/s [right side: P = .016, left side: P = .025] or 180°/s [right side: P = .007, left side: P = .029]). Besides, a considerably greater improvement in the areal BMD (P = .0006), volumetric BMD (P = .027), bone mineral content (P = .002), and BMD Z score (P = .0004) was observed in the AquaPlyo group. Moreover, a remarkably greater rise in the physical fitness (P < .001) was revealed in the AquaPlyo group. CONCLUSION AquaPlyo training can efficiently enhance muscle strength, improve bone mineral properties, and boost physical fitness in patients with juvenile idiopathic arthritis.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj,Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza,Egypt
| | - Mahmoud S Elfakharany
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza,Egypt
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Paretic-Limb-Only Plyometric Training Outperforms Volume-Matched Double-Limb Training for Ameliorating Balance Capability and Gait Symmetry in Adolescents with Unilateral Cerebral Palsy: A Comparative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101563. [PMID: 36291499 PMCID: PMC9600218 DOI: 10.3390/children9101563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Adolescents with unilateral cerebral palsy (U-CP) experience an asymmetrical posture because the less-affected lower limb is preferred for bodyweight support as a strategy of compensating for the paretic side’s muscular weakness. This study was designed to compare the effect of 12 weeks of paretic-limb-only plyometric training (PLPT) and volume-matched double-limb training (DLPT) on balance capability and gait symmetry in adolescents with U-CP. Sixty-nine adolescents with U-CP were randomly assigned to PLPT, DLPT, or a control group (n = 23 each). Treatment was delivered twice/week (with at least 48 h recovery intervals) for 12 weeks in succession. The directional (LoSdirectional) and overall (LoSoverall) limits of stability in addition to the temporal (T-GSI) and spatial (S-GSI) gait symmetry indicis were assessed pre- and post-treatment. The LoSdirectional improved significantly in the PLPT group compared to either the DLPT or control group (for the forward (p = 0.027 and <0.001, respectively), backward (p = 0.037 and <0.001, respectively), affected-side (p = 0.038 and 0.004, respectively), and less-affected-side (p = 0.018 and 0.016, respectively)), and this was also the case for the LoSoverall (p < 0.001). Additionally, The T-GSI and S-GSI scores decreased significantly in the PLPT group compared to the DLPT (p = 0.003 and 0.047, respectively) or control (p = 0.003 and 0.036, respectively) group, indicating the development more symmetrical gait patterns. In conclusion, PLPT is likely more effective for enhancing balance capabilities and promoting symmetrical gait patterns than DLPT. Thereupon, it is worthwhile for physical rehabilitation practitioners to include the PLPT paradigm into the intervention plans for adolescents with U-CP.
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