COMPARE THE EFFECTIVENESS OF DYNAMIC STRETCHING WITH CONVENTIONAL PHYSICAL THERAPY ON HAMSTRING FLEXIBILITY IN CHILDREN WITH SPASTIC CEREBRAL PALSY

Abstract

Background: Cerebral palsy is a permanent, non-progressive neurodevelopmental condition characterized by impaired movement, posture, and muscle tone, often resulting in functional limitations in daily activities. Spastic cerebral palsy is the most prevalent subtype and is commonly associated with hamstring shortening due to persistent spasticity, leading to restricted knee extension and compromised mobility. Stretching interventions are routinely used in rehabilitation; however, evidence comparing the effectiveness of dynamic and conventional stretching in children with spastic cerebral palsy remains limited.

Objective: To compare the effectiveness of dynamic stretching versus conventional stretching in improving hamstring flexibility in children with spastic quadriplegic cerebral palsy.

Methods: A pre-test/post-test quasi-experimental study was conducted over eight weeks at three pediatric rehabilitation centers in Lahore. Thirty-six children aged 5–14 years with spastic quadriplegic cerebral palsy were recruited using convenience sampling and divided into two equal groups. Both groups received standardized moist heat prior to intervention. One group underwent dynamic hamstring stretching, while the other received conventional stretching, under the supervision of certified physiotherapists. Therapy was administered for 30 minutes per session, five times per week, totaling 20 hours. Hamstring flexibility was assessed using goniometric measurement of the popliteal angle in a non-weight-bearing position before and after intervention.

Results: Within-group analysis demonstrated significant improvements in hamstring flexibility in both groups (p < 0.05). In the dynamic stretching group, mean improvement in popliteal angle was 9.44 ± 5.87 degrees in the left leg and 11.11 ± 6.12 degrees in the right leg. In the conventional stretching group, improvements were 6.33 ± 2.59 degrees in the left leg and 5.28 ± 1.93 degrees in the right leg. Between-group analysis revealed significantly greater improvements in the dynamic stretching group for both limbs (p < 0.05).

Conclusion: Both dynamic and conventional stretching were effective in improving hamstring flexibility in children with spastic cerebral palsy; however, dynamic stretching demonstrated superior outcomes, supporting its integration into routine pediatric neurorehabilitation programs.

Keywords: Cerebral palsy; Flexibility; Hamstring muscles; Physical therapy modalities; Rehabilitation; Spasticity; Stretching exercises