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
Ragab K. Elnaggar,
Rodrigo Ramirez-Campillo,
Alshimaa R. Azab,
Saud M. Alrawaili,
Mshari Alghadier,
Mazyad A. Alotaibi,
Ahmed S. Alhowimel,
Mohamed S. Abdrabo,
Mohammed F. Elbanna,
Ahmed M. Aboeleneen,
Walaa E. Morsy
Affiliations
Ragab K. Elnaggar
Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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
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
Mohammed F. Elbanna
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
Ahmed M. Aboeleneen
Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza 11432, Egypt
Walaa E. Morsy
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
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 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.
