To Determine Effectiveness of Closed-kinetic Chain Exercise on Motor Control and Function as Compared to Open-kinetic Chain Exercise in Children with Spastic Diplegic CP

Background and purpose: Traditionally, rehabilitation program emphasize strengthening training under close loop exercises. This study is designed to compare the effectiveness of closed-kinetic chain exercise v/s open-kinetic chain on motor function in children with spastic diplegic CP.

Method: 30 subjects with mild spastic diplegia (GMFCS level I-II) were selected on the basis of inclusion criteria and randomly assigned in two groups. Group A performed the loaded STS exercises 3 days a week, and 3 sets per day for 6 weeks. Group B performed progressive exercise training for 6 weeks, with three sessions per week, and at least one day's rest between sessions. 10-RM was calculated for the muscle selected.

Result: Student's t test while discrete data (Sex and GMFCS level) were analyzed with Fisher's exact est. The pre-test and post-test outcome measures (SCALE score, GMFM dimension D and GMFM dimension E) of two independent groups were compared by repeated measures analysis of variance (RM ANOVA) using general linear models (GLM) and the significance of mean difference within and between the groups was done by Newman-Keuls post hoc test.

Conclusion: study revealed that Progressive resisted lower limb strength training was found to be slightly (insignificant) more effective than Loaded sit-to-stand exercise. The SCALE score, GMFM Dimension D and GMFM Dimension E scores improved 1.08, 1.10 and 1.05 times more respectively in children those who received Progressive resisted lower limb strength training than those who received Loaded STS training.