Cerebral Palsy Clinical Trial
Official title:
Multi-Center Project: Supported Speed Treadmill Training Exercise Program (SSTTEP) for Marginally Ambulatory Children With Cerebral Palsy
The investigators are studying the effects of a 12-week exercise program, consisting of
either:
1. Walking on a treadmill with partial body weight
2. Functional exercise program
The investigators would like to know the effects these two exercise programs have on the
quality of life, muscle strength and control, coordination, walking, and functional movement
of children with cerebral palsy who are marginal ambulators. This is a randomized control
trial with subjects randomly assigned to one of the 2 groups.Subjects in both groups will be
seen twice a day for two weeks at our hospital for intervention and parent training, and
then participate in a 10 week home-based program. During each subject's two-week
clinic-based training, a parent or caregiver is trained in all home program exercises and/or
equipment usage. This person must be able to safely perform the exercise program with the
child. Each subject will also need to participate in three separate 5-hour long data
collection sessions scheduled over the 4 month study period.
This project proposes to answer the following questions: Is partial body weight supported
treadmill gait training (PBWSTT) effective in improving ambulation abilities, neuromuscular
impairments, functional mobility, disability, and quality of life in marginally ambulatory
children with cerebral palsy.
Specific Aim 1: Assess the effect of a PBWSTT locomotor training intervention on quality of
life, treatment expectations, self-efficacy, and activity and participation of children with
CP with limited ambulation skills. We hypothesize that in comparison to a control group,
after a 12 week locomotor intervention, children with CP (intervention group) with limited
ambulation skills will demonstrate greater improvements in scores from common questionnaires
compared to the control group.
Specific Aim 2: Assess the effect of a PBWSTT locomotor training intervention on gross motor
skills; physical function; biomechanics and coordination dynamics of ambulation; and
physical activity in ambulatory children with CP. We hypothesize that in comparison to a
control group, after a 12 week PBWSTT locomotor training intervention children with CP with
limited ambulation skills will demonstrate greater improvements in functional test scores
compared to the control group.
Specific Aim 3: Assess the effect of a PBWSTT locomotor training intervention on measures of
body structure and function including: spasticity; muscle strength; and joint-specific motor
control. We hypothesize that in comparison to a control group, after a 12 week PBWSTT
locomotor training intervention children with CP with limited ambulation skills will
demonstrate greater improvements in: muscle strength, spasticity and joint specific motor
control compared to the control group.
This is a single blinded, randomized, controlled pre-test/post-test study design. Sixty six
ambulatory children between the ages of 6-12 years of age with cerebral palsy will undergo a
12-week training program. Thirty three of these children will undergo a Supported Speed
Treadmill Training Exercise Program (SSTTEP), and the remaining 33 children will receive the
same amount of conventional physical therapy in the form of a personalized home exercise
program and serve as a control group. Three sets of measures will be obtained: A1) at
baseline prior to intervention; A2) at the end of the 12-week intervention period; and A3) 4
weeks after the intervention has ended.
The two primary aims of our study are to assess the efficacy of SSTTEP in improving quality
of life, functional ambulation, energy expenditure, gross motor skills, and muscle strength
and tone; and to assess the efficacy of SSTTEP in improving the coordination of stepping and
ambulation in children with CP.
The intervention group will undergo a program of 10 hours of intensive SSTTEP training over
a 14 day period. After the initial training, the subjects will participate in a home program
of 30 minutes/5 times per week for an additional 10 weeks.
The control group with undergo a personalized exercise program consisting of 10 hours of
intensive training over a 14 day period. After the initial training, the subjects will
participate in a home program of 30 minutes/5 times per week for an additional 10 weeks.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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