Trunk and Upper Extremities Program Effect in Decreasing Compensation Patterns in Unilateral Cerebral Palsy Children (TUPEX)

Trunk and Upper Extremities Program Effect in Decreasing Compensation Patterns in Unilateral Cerebral Palsy Children

Trunk and Upper Extremities Program Effect in Decreasing Compensation Patterns in Unilateral Cerebral Palsy Children: Randomized Control Trial

The goal of this clinical trial is to test the effectiveness of a trunk and upper extremities exercise program. The main questions it aims to answer are: Whether the program decreases compensation patterns in unilateral cerebral palsy children Whether the program decreases pain in unilateral cerebral palsy children Whether the program improves bimanual ability in unilateral cerebral palsy children Participants will undertake and 8-week program exercise at home If there is a comparison group: Researchers will compare with the control group to see if this program decreases compensation patterns.

Children in control group will continue with their daily activities. Children in experimental group, apart from their daily activities, will undertake an 8-week program exercise at home for strengthening the trunk and the proximal part of both upper extremities. It contains 3 progressions that can be applied if needed.

One member of the research team responsible for carrying out the evaluations of the dependent variables and the collection of data carried out by the participant himself and/or his families, will remain blinded to the assignment of the participants to the study groups. In this sense, it is worth saying that the person responsible for carrying out the evaluations will do so only for the main variable, that is to say, he will be the one who will carry out the registration of the compensatory movements of the proximal part of the upper limb and trunk through the DLC . The secondary response variables are evaluated through self-administered scales and this same evaluator will be in charge of collecting the data provided by the families.

Children in this group will continue with their daily activities such as conventional physiotherapy and occupational therapy, even psychology, and their physical activities such as swimming or playing football.

Children in this group will continue with their daily activities and will add the TUPEX program during 8 weeks.

This program contains exercises with their own body weight or with Thera-bands for gaining strength in their shoulder and trunk muscles. It contains some progression exercise if needed. Each session can last between 20 and 30 minutes. Children have to do each session three times a week during 8 weeks.

DeepLabCut (DLC) (Artificial Intelligence). Calculate the kinematic difference of the body marks during the activities

Face Pain Scale - Revised (FPS-R). The face marked is compared before and after the treatment. 0 is the minimum scores, meaning no pain, and 10 is the maximum score, meaning really severe pain.

Children Hand-Use Experience Questionaire 2.0 (CHEQ 2.0). Whether they are more capable of doing more bimanual activities or not. The maximum score in each question is 100 and the minimum is 0. 100 means children use their hands like the neurotypical children, and 0 means they can't use the affected hand at all.

Inclusion Criteria: Unilateral cerebral palsy diagnostic Level I or II of the Manual Ability Scale Classification Exclusion Criteria: Have received any intervention with botulinum toxin or shock waves in the previous six months or have them scheduled during the intervention Are undergoing treatment with intensive therapies. To have known alteration in the hips Have very serious attention or comprehension difficulties that prevent them from following instructions. Suffer uncontrolled epilepsies Suffer from severe visual problems.

The results could be submitted for publication in Clinical Rehabilitation, Therapeutic Advances in Chronic Disease, Acta Pediatrics or in Developmental Medicine & Child Neurology (DMCN). It is also planned to disseminate the knowledge obtained to different associations in the field of physiotherapy in pediatrics such as the Spanish Association of Intervention in the Early Childhood (AEIPI) and the Spanish Pediatric Association (AEP) or Association of Infantile Hemiparesis. Regarding the presentation at congresses, it is planned to present the results of this study at the annual congress of the European Academy of Childhood Disability, that of the Spanish Society of Child Rehabilitation or the National Congress of Rehabilitation.

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