Effect of Pulley System Exercise on Upper Limb Function in Hemiplegic Cerebral Palsy Children

OBJECTIVE: To evaluate the effect of pulley system exercises combined with conventional therapy on upper-limb function in children with hemiplegic CP. DESIGN: A randomized controlled trial was conducted with 32 children aged 3-7 years with hemiplegic CP. Participants were allocated to an intervention group (A) receiving pulley system exercises alongside conventional therapy or a control group (B) receiving conventional therapy alone. Outcomes measured pre- and post-intervention included the Assisting Hand Assessment (AHA), Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), and isometric muscle strength. RESULTS: Both groups improved significantly, but the intervention group showed significantly greater gains in bimanual performance, motor coordination, and muscle strength compared to controls ( P <0.01). CONCLUSION: Incorporating structured pulley system exercises with conventional therapy significantly enhances upper-limb function in children with hemiplegic CP. This affordable, adaptable approach may optimize rehabilitation outcomes by delivering high-repetition, progressively loaded, task-specific practice.