Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Children with Spastic Diplegia: A Study Protocol for a Randomized Clinical Trial

Abstract

Background: Cerebral Palsy is a spacious term which highlights an extensive gamut of motor affliction which has a stagnant tendency. The estimated Cerebral Palsy is indeed very prevalent in developed nations 2 out of the next 1000 live births and neonatal survivors. Among several Cerebral Palsy comes in a variety of manifestations. Spastic Diplegia is common in a majority of Preterm babies. Several treatment strategies of Physical therapy are utilized for Spastic Diplegia. This research focusses on assessing the Efficiency of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) techniques over the Dimensions of Balance and Gait in children with Spastic Diplegia. Objective: To evaluate the Effectiveness and impact of the techniques of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) on Balance, Gait Parameters and Pelvic Asymmetry in children having Spastic Diplegia. Methods: In this Randomized Clinical Trial, subjects (n= 40) having Spastic Diplegia will be selected and segregated in two groups using simple random sampling method with 1:1 allocation ratio. The allocation will be done through sequentially numbered opaque sealed envelope (SNOSE). Subjects in the experimental group will receive Pelvic PNF techniques like Rhythmic initiation and Slow reversal with Task- Oriented training which will contain sit to stand exercises, walking on the ground and reaching tasks for improving the balance and those in the other group will be given only Task- Oriented training for 4 weeks following baseline assessments. Throughout the treatment session and following 4 weeks follow up will be taken by assessing the Balance and Gait parameters of the subjects. The study duration will.  be of 1 year. Subjects with Spastic Diplegia with an age group of 8 to 12 years  who are able to do independent sitting, who are coming under GMFCS level I to III and those who are having pelvic asymmetry will be included in the study while subjects who had any surgery of spine or lower limb in past 6 months, who are having fixed deformities of spine or lower limb or any fracture or dislocation of spine or lower limb will be excluded from the study.  Results: Results will be recorded by using the outcome measures and instruments such as Pediatric Balance Scale, Gait Parameters and Palpation meter device at the end of the intervention and the effects of Pelvic PNF techniques will be compared with the other group which will receive Task oriented training. The statistical analysis will be done by using paired t test but if the data does not follow a normal distribution then Wilcoxon sign rank test will be used.           Discussion: The intention and motive of the study is to check the Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation techniques on Balance and Gait Parameters in children with Spastic Diplegia. Conclusion: The conclusion of this research is to acquire the fruitfulness of Approaches of Pelvic PNF on Balance and Gait Parameters in children having Spastic Diplegia.