Effectiveness of Universal Exercise Unit Exercise on Upper Limb Strength Using Biodex Isokinetic

This study is designed to answer the following question:

Is there an effect of designed program in universal exercise unit on upper limb function and strength in children with spastic hemiplegia? Purpose of The Study The purpose of the study is to determine the role of designed program in the universal exercise unit on upper limb function and strength in children with spastic hemiplegia.

Null Hypothesis Is there is no role of designed program in the universal exercise unit on the upper limb in children with spastic hemiplegia.

The study was concluded forty children with spastic hemiplegic cerebral palsy from both sexes had been selected from according to the following criteria:

• children ages were ranged from 5-9 years old.
• The children had spasticity grades 1, 1+ degree according to Modified Ashworth scale
• The children were selected to be in level I and II GMFCs
• The children were selected to be in level II MACs participants had been excluded if they had the following:

• Visual or hearing impairment
• Orthopedic surgery of upper limbs for the last 6 months
• Cardiopulmonary diseases Children were equally assigned into two groups using simple randomization, control group (A) and study group (B). Each group would consist of 20 children with spastic hemiplegia CP.

Group (A): Children in this group received a selected physical therapy program. Group (B): Children in this group received the selected physical therapy program in addition to a designed physical therapy program in UEU.

Evaluation was carried out for each child individually before and after 3 months of treatment.

A-For Assessment

• The Quality of Upper Extremity Skill Test (Quest) The QUEST test included 34 items in four domains of (dissociated movement, grasp, weight bearing and protective extension).

Each child was instructed to hold the position for at least two seconds. The total testing timing including the administration and scoring was approximately 45 minutes.

The scoring was performed and recorded in scoring box. Even if the item was not tested (I.e: yes, no, not tested)

• The Biodex Isokinetic system The testing session had been started with a warm up procedure, consisting of shoulder movements in all directions, push up-exercises against the wall and stretching. For the testing procedure, the closed chain attachment was fixed to the isokinetic dynamometer in a horizontal position. Essentially, this device converts rotational motion at the dynamometer into linear motion, allowing closed kinematic chain or linear movements The evaluation was carried out for each child individually before and after three month of treatment.

Tested muscles were elbow flexors, elbow extensor, shoulder flexors, shoulder extensors.

Inclusion criteria

• Their ages were ranged from 5-9 years old.
• They had spasticity grades 1, 1+ degree according to Modified Ashworth scale
• They were selected to be in level I and II GMFCs They were selected to be in level II MACs

Exclusion criteria

• Visual or hearing impairment
• Orthopedic surgery of upper limbs for the last 6 months
• Cardiopulmonary diseases