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Comparison of Hold Relax And Contract Relax Techniques in Improving ROM across Knee Joint in Children with Spastic Cerebral Palsy

. Rimsha siddique, Huma Khan, Sumbal Salik, Laila Niaz Khan, Raheel Munawar & Asna Waseem


Abstract

Background: Spastic cerebral palsy is upper motor neuron lesion in which permanent abnormality in the cerebral cortex of brain so there is not a cure for it. Physical therapy interventions are including Hold relax and Contract relax help to reduce the spasticity in hamstring in spastic cerebral palsy.

Objective: To compare the effects of hold relax and contract relax techniques on improving range of motion (ROM) across knee joint in children with spastic cerebral palsy.

Material and Method: A randomized control trial study was conducted on 20 patients suffering from spastic cerebral palsy at Physiotherapy Department of PSRD Lahore from 16 April to 16 august 2022. The patients were randomly allocated in two groups treated with conventional protocol Group A was treated with hold relax technique. Group B was treated with contract relax technique. The whole session was completed with 6 sets of exercises within 40-45 minutes. The evaluation was done through the Goniometer and Gross Motor Function Classification System (GMFCS) for the assessment of knee ranges and disability level. The data was analyzed through SPSS in which demographic data was presented in frequency (%), Mean ±S.d along with within and across the group difference described through the Wilcoxon and Mann Whitney test as data was not normally distributed with p-value <0.05.

Results: The result of study showed that Hold relax improves Right knee and Left knee ranges with p-value =0.038 and 0.052 respectively. Similarly; Contract Relax improves Right knee with p-value =0.004 and Left knee with p-value =0.005. Furthermore; inter-group comparison of Right knee results showed Hold relax was 7.95 while Contract Relax was 13.05 with p-value =0.048 and d = 0.052. While inter-group comparison of Left knee reported Hold relax were 8.85 while Contract Relax was 12.15 with p-value =0.007 and d = 0.018. This showed Hold relax was statistically significant in treating Knee ranges especially knee extension.

Conclusion: The study concluded that Hold relax and Contract relax both are effective in improving knee ranges especially knee extension. However; Hold relax is statistically significant in enhancing knee extension by reducing the tightness of affected knee hamstring muscles.

Index Terms: Contract relax technique, Hamstring flexibility, Hold relax technique, Spastic Cerebral palsy.

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