Comparison between Task-Oriented Training and Proprioceptive Neuromuscular Facilitation Exercise on Upper Extremity Function in Spastic Cerebral Palsy

Srilakshmi .; Arun Selvi; Mahesh Kumar P.G.; Hari Hara Subramanyan P.V.; Shenbaga sundaram Subramanian; Thamer A. Altaim; Shadi Abdelbaset Alkhob; Riziq Allah Mustafa Gaowgzeh

doi:10.52756/ijerr.2024.v39spl.008

Authors

Srilakshmi . Faculty of physiotherapy, Dr. M. G. R. Educational and Research Institute, Chennai, India https://orcid.org/0000-0003-2112-2720
Arun Selvi Faculty of physiotherapy, Dr. M. G. R. Educational and Research Institute, Chennai, India https://orcid.org/0000-0002-5197-7781
Mahesh Kumar P.G. Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research, Chennai, India https://orcid.org/0000-0002-2465-9462
Hari Hara Subramanyan P.V. Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research, Chennai, India https://orcid.org/0000-0001-5487-5281
Shenbaga sundaram Subramanian Chettinad School of Physiotherapy (CSP), Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Tamil Nadu 603103, India https://orcid.org/0000-0002-6150-0928
Thamer A. Altaim Department of Physical Therapy, Faculty of Allied Health Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan http://orcid.org/0000-0001-6527-4289
Shadi Abdelbaset Alkhob Department of Physical Therapy, Faculty of Applied Medical Science, Jerash University, Jerash, Jordan https://orcid.org/0009-0009-4565-3818
Riziq Allah Mustafa Gaowgzeh Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia https://orcid.org/0000-0003-4199-2600

DOI:

https://doi.org/10.52756/ijerr.2024.v39spl.008

Keywords:

Cerebral palsy, Motor impairment, Spastic, Proprioceptive Neuromuscular Facilitation (PNF),, Upper extremity function, Task-oriented training

Abstract

This research investigates and compares the impacts of task-oriented training and proprioceptive neuromuscular facilitation (PNF) on the motor function of the affected arm in children diagnosed with spastic cerebral palsy (CP). The study addresses the need for effective interventions to address the motor challenges in this population. Thirty participants were randomly assigned to either Group A (task-oriented training) or Group B (PNF training) in a two-month comparative study conducted in special schools. Both groups participated in daily 40-minute sessions five days a week for eight weeks. Pre and post-tests, utilizing the Assistive Hand Assessment (AHA-22) and Manual Ability Measure (MAM-16), were administered to evaluate outcomes. The analysis revealed no significant differences in post-test scores between Group A and Group B, indicating comparable effectiveness of both interventions in improving upper extremity function in children with spastic cerebral palsy. This study contributes valuable insights into therapeutic approaches for enhancing motor function in children with spastic cerebral palsy. Both task-oriented training and proprioceptive neuromuscular facilitation emerge as effective methodologies, providing healthcare professionals and educators with evidence-based options for optimizing outcomes in this population. These findings hold international relevance, offering a foundation for informed decision-making in the selection of interventions for children with spastic cerebral palsy across diverse global contexts.

References

Ahl, L. E., Johansson, E., Granat, T., & Carlberg, E. B. (2005). Functional therapy for children with cerebral palsy: an ecological approach. Developmental Medicine and Child Neurology, 47(9), 613–619. https://doi.org/10.1111/j.1469-8749.2005.tb01213.x

Arun, S.J., M., S., Subramanyan P.V., H., Kumar P.G., M., Subramanian, S. Sundaram, Altaim, T., Alkhob, S., & Gaowgzeh, R. A. (2024). Comparing the Effectiveness of Soft Tissue Manipulation and IASTM for Calf Muscle Tightness in Spastic Cerebral Palsy Children. International Journal of Experimental Research and Review, 38, 225-235. https://doi.org/10.52756/ijerr.2024.v38.020

Basak, S., & Dutta, S. (2016). A comparative study of physical fitness parameters between General college students and Training college students. Int. J. Exp. Res. Rev., 4, 26-30. Retrieved from https://qtanalytics.in/journals/index.php/IJERR/article/view/1356

Basak, S., & Biswas, K. (2016). A study of selective physiological parameters in physical training college students. Int. J. Exp. Res. Rev., 3, 1-6.

Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., Jacobsson, B., Damiano, D., & Executive Committee for the Definition of Cerebral Palsy (2005). Proposed definition and classification of cerebral palsy, April 2005. Developmental Medicine and Child Neurology, 47(8), 571–576. https://doi.org/10.1017/s001216220500112x

Blundell, S.W., Shepherd, R.B., Dean, C.M., Adams, R.D., & Cahill, B.M. (2003). Functional strength

training in cerebral palsy: A pilot study of a group circuit training class for children aged 4–8 years. Clinical Rehabilitation, 17, 48–57. https://doi.org/10.1191/0269215503cr584oa

Chen, C. C., Granger, C. V., Peimer, C. A., Moy, O. J., & Wald, S. (2005). Manual Ability Measure (MAM-16): a preliminary report on a new patient-centered and task-oriented outcome measure of hand function. Journal of Hand Surgery (Edinburgh, Scotland), 30(2), 207–216. https://doi.org/10.1016/j.jhsb.2004.12.005

Chrysagis, N., Douka, A., Nikopoulos, M., Apostolopoulou, F., & Koutsouki, D. (2009). Effects of an aquatic program on gross motor function of children with spastic cerebral palsy. Biology of Exercise, 5. https://doi.org/10.4127/jbe.2009.0027

Khanna, S., Arunmozhi, R., & Goyal, C. (2023). Neurodevelopmental Treatment in Children With Cerebral Palsy: A Review of the Literature. Cureus, 15(12). https://doi.org/10.7759/cureus.50389

Khant, A., Dave, Y., Tare, H., Udugade, B., Udugade, S., Choudante, S., & Pulate, C. (2023). Effectiveness of respiratory muscle training on pulmonary function and quality of life in cotton industry workers. Int. J. Exp. Res. Rev., 32, 160-165. https://doi.org/10.52756/ijerr.2023.v32.013

Kolit, Z., & Ekici, G. (2023). Effect of the cognitive orientation to daily occupational performance (CO-OP) approach for children with cerebral palsy: A randomized controlled trial. Journal of Pediatric Rehabilitation Medicine, 16(1), 59-70. https://doi.org/10.3233/prm-210085

Krigger, K. W. (2006). Cerebral Palsy: An Overview. American Family Physician, 73(1)

Krumlinde-Sundholm, L., Holmefur, M. (2007). The Assisting Hand Assessment: Current evidence of validity, reliability, and responsiveness to change. Developmental Medicine & Child Neurology, 49, 259–264. https://doi.org/10.1111/j.1469-8749.2007.00259.x

Kulinski, W., & Adamczyk, E. (2023). Physical therapy in cerebral palsy. Clinical aspects. Case report. Acta Balneologica, 4, 197. https://doi.org/10.36740/abal202304101

Kumar, C., & Ostwal, P. (2016). Comparison between task-oriented training and proprioceptive neuromuscular facilitation exercises on lower extremity function in cerebral palsy: A randomized clinical trial. Journal of Novel Physiotherapies, 6(3), 1000291. http://dx.doi.org/10.4172/2165-7025.1000291

Lindquist, A., Ribeiro, T., Silva, E., & Galvão, E. (2011). Poster 89 Influence of Treadmill Training with Body Weight Support and Proprioceptive Neuromuscular Facilitation on Hemiparetic Gait. Archives of Physical Medicine and Rehabilitation, 92(10), 1718. https://doi.org/10.1016/j.apmr.2011.07.114

Marda, M., & Thorat, K. (2023). Effect of task-oriented balance training versus virtual reality-based balance training in stroke patients-a comparative study. Pravara Medical Review, 15(4). https://doi.org/10.36848/PMR/2023/00000.511228

Moon, J. H., Jung, J. H., Hahm, S. C., & Cho, H. Y. (2017). The effects of task-oriented training on hand dexterity and strength in children with spastic hemiplegic cerebral palsy: a preliminary study. Journal of Physical Therapy Science, 29(10), 1800–1802. https://doi.org/10.1589/jpts.29.1800

Nikolovska, L., & Ismani, B. (2023). Effectiveness of physical therapy and rehabilitation in improving motor skills and mental function in children with cerebral palsy. MEDIS–International Journal of Medical Sciences and Research, 2(4), 23-26. https://doi.org/10.35120/medisij020423n

Nshimiyimana, J., Uwihoreye, P., Muhigirwa, J. C., & Niyonsega, T. (2023). Neurofunctional Intervention Approaches. In Neurorehabilitation and Physical Therapy. IntechOpen. https://doi.org/10.5772/intechopen.106604

Oh, S. J. (2023). Analysis of the Impacts of Task-oriented Backward Walking Training on the Gross Motor Function and Balance Ability of Children with Hemiparesis. Journal of Korean Society for Neurotherapy, 27(1), 61-67.

Olubukola, A. O., Olugbenga, S. P., Christopher, O. A., & Babatunde, O. A. A. (2021). Relationship between post-stroke spasticity and functional ambulation among Nigerian stroke survivors. Journal of the Nigeria Society of Physiotherapy, 20(1), 16–20. https://doi.org/10.5897/JNSP2021.0011

Oskoui, M., Coutinho, F., Dykeman, J., Jette, N., Pringsheim, T. (2013). An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Developmental Medicine & Child Neurology, 55, 509–519. https://doi.org/10.1111/dmcn.12080

Poonam, C., AjaiKumanm S., Vandana, T., Anup, K. T. (2020). Post-stroke BDNF concentration changes following proprioceptive neuromuscular facilitation (PNF) exercises. J. Family Med. Prim. Care, 2020, 3361-3369.

Raina, P., O’Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., Swinton, M., Zhu, B., & Wood, E. (2005). The Health and Well-Being of Caregivers of Children With Cerebral Palsy. Pediatrics, 115(6), e626–e636. https://doi.org/10.1542/peds.2004-1689

Rensink, M., Schuurmans, M., Lindeman, E., & Hafsteinsdóttir, T. (2009). Task‐oriented training in rehabilitation after stroke: Systematic review. Journal of Advanced Nursing, 65(4), 737–754. https://doi.org/10.1111/j.1365-2648.2008.04925.x

Schneiberg, S., Mckinley, P. A., Sveistrup, H., Gisel, E., Mayo, N. E., & Levin, M. F. (2010). The effectiveness of task‐oriented intervention and trunk restraint on upper limb movement quality in children with cerebral palsy. Developmental Medicine & Child Neurology, 52(11). https://doi.org/10.1111/j.1469-8749.2010.03768.x

Shahid, J., Kashif, A., & Shahid, M. K. (2023). A Comprehensive Review of Physical Therapy Interventions for Stroke Rehabilitation: Impairment-Based Approaches and Functional Goals. Brain Sciences, 13(5), 717. https://doi.org/10.3390/brainsci13050717

Shih, T. Y., Wang, T. N., Shieh, J. Y., Lin, S. Y., Ruan, S. J., Tang, H. H., & Chen, H. L. (2023). Comparative effects of kinect-based versus therapist-based constraint-induced movement therapy on motor control and daily motor function in children with unilateral cerebral palsy: a randomized control trial. Journal of NeuroEngineering and Rehabilitation, 20(1), 13. https://doi.org/10.1186/s12984-023-01135-6

Shimura, K., & Kasai, T. (2002). Effects of proprioceptive neuromuscular facilitation on the initiation of voluntary movement and motor evoked potentials in upper limb muscles. Human Movement Science, 21(1), 101–113. https://doi.org/10.1016/S0167-9457(01)00057-4

Song, C.S. (2014). Effects of task-oriented approach on affected arm function in children with spastic hemiplegia due to cerebral palsy. Journal of Physical Therapy Science, 26, 797–800. https://doi.org/10.1589/jpts.26.797

Sporea, C., Morcov, M. V., Morcov, M., & Mirea, A. (2023). Effectiveness of Passive Movement Training in Patients with Cerebral Palsy: A Comparative Analysis of Robot-Assisted Therapy and Electrical Stimulation in Hand Rehabilitation. Balneo and PRM Research Journal, 14(4), 623. https://doi.org/ 10.12680/balneo.2023.623

Talgeri, A. J., Nayak, A., Karnad, S. D., Jain, P., Tedla, J. S., Reddy, R. S., & Sangadala, D. R. (2023). Effect of Trunk Targeted Interventions on Functional Outcomes in Children with Cerebral Palsy-A Systematic Review. Developmental Neurorehabi-litation, 26(3), 193-205. https://doi.org/10.1080/17518423.2023.2193265

Ketelaar, M., Vermeer, A., Hart, H., Beek, E.V.P.V., & Helders, P.J.M. (2001). Effects of a Functional Therapy Program on Motor Abilities of Children With Cerebral Palsy, Physical Therapy, 81(9), 1534–1545. https://doi.org/10.1093/ptj/81.9.1534

Yeargin-Allsopp, M., Van Naarden Braun, K., Doernberg, N. S., Benedict, R. E., Kirby, R. S., & Durkin, M. S. (2008). Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Paediatrics, 121(3), 547–554. https://doi.org/10.1542/peds.2007-127