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To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP). A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group;  n  = 19), balance exercises (BAL group,  n  = 19), and combined plyometric and balance exercises (PLYO-BAL group;  n  = 19). The maximum isometric muscle strength (IMS max ) and postural stability [anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)] were measured pre- and post-intervention. By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMS max  than the PLYO and BAL groups for the quadriceps ( p =.03 and  p =.0002 respectively), hamstrings ( p =.018 and  p &lt;.0001 respectively), and dorsiflexors ( p =.006 and  p &lt;.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI ( p &lt;.0001 and  p =.0001 respectively), ML-SI ( p =.001 and  p =.015 respectively), and O-SI ( p =.011 and  p =.04 respectively). Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP.

physical and occupational therapy in pediatrics

Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial