Hemiplegic Cerebral Palsy Clinical Trial
Official title:
Robotic Rehabilitation and Brain Stimulation for Children With Hemiparetic Cerebral Palsy
This study evaluates the use of robotic rehabilitation with and without transcranial direct current stimulation (tDCS) to improve motor performance in children with hemiparetic cerebral palsy. Half of the participants will receive robotic rehabilitation and half will receive robotic rehabilitation with tDCS. We hypothesize that tDCS may augment the robotic therapy and show greater improvements than robotic therapy alone.
The defining feature of hemiparetic cerebral palsy is motor impairments primarily on one side
of the body. Robotic rehabilitation and non-invasive brain stimulation are both emerging
technologies that may be beneficial in improving motor performance in individuals with
hemiparetic cerebral palsy. Robotic rehabilitation can allow for hundreds of arm movements in
the span of an hour, a level of concentrated repetitions that is not possible in traditional
rehabilitation. Additionally, robotics can target specific deficits, such as coordinating
both arms together, improving accuracy of reaching movements, or improving proprioception,
while simultaneously giving the therapist and patient quantitative feedback on performance.
Non-invasive brain stimulation using transcranial direct current stimulation (tDCS) can
safely modulate activity in regions of the brain and has emerged as a tool to enhance motor
learning in typically developing children and augment therapy in children with hemiparetic
cerebral palsy.
Children with hemiparetic cerebral palsy will be randomized to receive robotic rehabilitation
with tDCS or robotic rehabilitation with sham-tDCS. Participants and the assessors will be
blinded to the treatment. All children will complete 10 sessions within 3 weeks of 1.5 hours
of robotic rehabilitation. The Kinarm Exoskeleton Robot will be used and children will play
games with their affected arm or both arms to target different aspects of sensorimotor
control. Children will simultaneously receive real or sham tDCS for the first 20 minutes of
the session. tDCS will consist of 1 mA current with the cathode applied over the
contralesional M1 area. All children will be assessed before and after the 10 session
intervention period using robotic and clinical measures of motor and sensory performance, and
at a 3 month follow up.
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