Cerebral Palsy Clinical Trial
Official title:
Linking Neuroplasticity With the Outcomes of Walking-based Interventions: A Feasibility Trial Comparing a Motor Learning Versus a Strength-based Program in Children With Cerebral Palsy
NCT number | NCT02754128 |
Other study ID # | 16-624 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | June 2016 |
Est. completion date | October 2017 |
Verified date | November 2017 |
Source | Holland Bloorview Kids Rehabilitation Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of this study is to compare a motor learning (ML)-based gait-related training
intervention to a functional lower limb strength training intervention, with a concurrent
evaluation of functional, neural and participation outcomes for children and youth with
Cerebral Palsy (CP).
This study is a two-group, parallel arm RCT in which twenty-two children with CP in GMFCS
Levels I-II will be randomly allocated to a 6-week, 16 session program of: (i) ML based gait
training or (ii) lower limb strength training. Outcome assessments occur pre/post/4-months
post-intervention.
Status | Completed |
Enrollment | 20 |
Est. completion date | October 2017 |
Est. primary completion date | October 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 7 Years to 17 Years |
Eligibility |
Inclusion Criteria: - 7-17 years old - diagnosis of hemiplegic or diplegic Cerebral Palsy - GMFCS Level I-II - able to follow testing and motor imagery instructions - able to actively participate in a minimum of 45 minutes (min) of physical activity - show evidence of independent dorsiflexion of both ankles - able to commit to attendance of sessions two to three times weekly for six weeks. Exclusion Criteria: - orthopaedic surgery within the last 9 months (muscle) or 12 months (bone) - Botulinum toxin-A (BTX-A) injections to lower limb in the last 4 months - inability to put BTX-A on hold during trial - severe spasticity (may be a contraindication for neuroimaging procedures) - seizure disorder (if not fully controlled by medication for 12 months) - not prepared or unable to discontinue any formal lower limb therapy intervention or physical activity program during the trial - involved in another intervention study - standard MRI contraindications (e.g., magnetic implants, inability to lay still, claustrophobia etc.) |
Country | Name | City | State |
---|---|---|---|
Canada | Holland Bloorview Kids Rehabilitation Hospital | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
Holland Bloorview Kids Rehabilitation Hospital | The Hospital for Sick Children, University of Toronto |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Motor learning as evaluated using retention and transfer tests | Individualized skills will be identified to practice at every session (retention) and only at sessions 5/10/15 (transfer) to evaluate motor learning | Week 2, 4, 6 | |
Other | Motor learning content of interventions, as assessed using the Motor Learning Strategy Rating Instrument (MLSRI) | The MLSRI is used to assess the extent to which motor learning strategies are used within an intervention session | Week 2, 4, 6 | |
Other | Intervention program enjoyment, assessed using a modified version of the Physical Activity Enjoyment Scale (PACES) | Participants' enjoyment of the intervention program will be assessed following the intervention | 7 days post training intervention | |
Other | Intervention session enjoyment | Participants' enjoyment of each session will be assessed using a study-specific questionnaire | 16 times over 6 weeks (following each intervention session) | |
Other | Rating of exertion, assessed using Pictorial Children's Effort Rating Table (PCERT) | Children will be asked to complete PCERT at mid-point of each session, and 2 minutes before session completion | Completed at 22 minutes (mid-point) and at 43-minutes (2-minutes before end) of each intervention session | |
Other | Heart rate (beats per minute) | Heart rate will be monitored by treating staff member via radial pulse. | Assessed at 4 time points per session: 1 min before start of session, at 22 minutes (mid-point), at 43-minutes (2-min before end), and at 45-minutes (end) of each session | |
Other | Body pain | Use of FACES pain scale and body diagrams to show areas of pain (musculoskeletal and other) | Completed 2 minutes before and 2 minutes after each intervention session | |
Other | Parent Satisfaction scale | Parent's satisfaction and perceived benefit of intervention will be assessed using a study-specific questionnaire | 7 days post training intervention | |
Other | Staff Satisfaction scale | Staff satisfaction and perceived benefit of intervention for each child in the study will be assessed using a study-specific questionnaire | 7 days post training intervention | |
Other | Lower limb strength | A 30 second lateral step-up test will be used bilaterally to assess functional lower limb strength | 7 days pre/7days post/4-months post intervention | |
Other | Ankle range of motion and dorsiflexion force | Passive and active ROM will be assessed using a goniometer | 7 days pre/7days post/4-months post intervention | |
Other | Dorsiflexion force | Dorsiflexion force will be assessed using surface electromyography (EMG) | 7 days pre/7days post/4-months post intervention | |
Other | Change from baseline in lower-limb proprioception | Lower limb joint-sense position will be assessed using a semi-goniometer (protocol modified from Wingert et al, 2009) | 7 days pre/7days post/4-months post intervention | |
Other | Mental chronometry | Participants will be timed while walking a 10-meter distance, and then timed while imagining walking the same distance. | 7 days pre/7days post/4-months post intervention | |
Other | Motor Imagery Questionnaire for Children (MIQ-C) | Participant's motor imagery ability will be assessed using the 12-item MIQ-C | 7 days pre/7days post/4-months post intervention | |
Other | Feasibility process indicators: recruitment rate | Recruitment rate: # eligible participants as compared to # screened and # enrolled | Through study completion, an average of 6-months | |
Other | Feasibility process indicators: perceived intervention benefit | Perceived intervention benefit calculated as combined child/parent rating | Through study completion, an average of 6-months | |
Other | Feasibility process indicators: retention rate | Number of children enrolled as compared to number of children who complete the study | Through study completion, an average of 6-months | |
Other | Feasibility resource indicators: adherence rate | Number of sessions completed | Through study completion, an average of 6-months | |
Other | Feasibility resource indicators: data collection time | Projected vs actual data collection time | Through study completion, an average of 6-months | |
Other | Feasibility resource indicators: data collection completion | Percent missing data | Through study completion, an average of 6-months | |
Other | Feasibility management indicators: Intervention fidelity | Within session effort scores | Through study completion, an average of 6-months | |
Other | Feasibility management indicators: Intervention fidelity/contamination | Video sessions every 2 weeks to assess session content: (i) STRONG group: 1RM lower limb strength progression; (ii) FAST group: Session content via Motor Learning Strategy Rating Instrument (MLSRI) | Through study completion, an average of 6-months | |
Other | Feasibility management indicators: Intervention fidelity | Completion of diaries for motor imagery/strength home practice | Through study completion, an average of 6-months | |
Other | Feasibility management indicators: Intervention fidelity/contamination | Log books for PA-participation tracking/management in active intervention and 4 month follow-up | Through study completion, an average of 6-months | |
Other | Feasibility management indicators:Treatment administration | PTA/RKin session summary form data | Through study completion, an average of 6-months | |
Other | Feasibility management indicators: Acceptability of intervention | Aggregate score of: Parent/staff satisfaction scale, child Physical Activity Enjoyment Scale (PACES), child intervention satisfaction score | Through study completion, an average of 6-months | |
Other | Feasibility science indicators | Treatment response | Through study completion, an average of 6-months | |
Other | Feasibility science indicators:adverse events | Number of adverse events | Through study completion, an average of 6-months | |
Primary | Change from baseline in advanced motor skills on the Challenge Module | The Challenge Module is a new published measure of advanced motor skills. | 7 days pre/7 days post/4-months post training intervention | |
Secondary | Change from baseline in functional activity in lower-limb related cortical areas, assessed using functional MRI (fMRI) | 7 days pre/7 days post training intervention | ||
Secondary | Change from baseline in resting state activity, assessed using resting state fMRI | 7 days pre/7 days post training intervention | ||
Secondary | Change from baseline in microstructure of brain, assessed using diffusion tensor imaging (DTI) | 7 days pre/7 days post training intervention | ||
Secondary | Change from baseline in Physical Activity self-efficacy | Participant-report measure of Task efficacy and Barrier efficacy for physical activity. | 7 days pre/7days post/4-months post training intervention | |
Secondary | Change from baseline in walking activity, assessed using an Actigraph accelerometer | 7 days pre/7days post/4-months post training intervention | ||
Secondary | Change from baseline in gait kinematics as measured using an electronic walkway | Time/distance parameters of footsteps via GAITRite system. | 7 days pre/7days post/4-months post training intervention | |
Secondary | Change from baseline in physical activity participation, as measured using the Participation and Environment Measure for Children/Youth (PEM-CY) | Parent-report measure of participation in the home, school and community, as well as environmental factors within each setting. | 7 days pre/7days post/4-months post training intervention | |
Secondary | Change from baseline in walk speed on the Six-minute walk test | Standardized 6 minute walk test (with shoes, orthoses as required) to determine distance covered (capability measure). Well-validated in pediatric CP. | 7 days pre/7days post/4-months post training intervention | |
Secondary | Change from baseline in targeted goal abilities and satisfaction with performance as measured by the Canadian Occupational Performance Measure | Three to five individualized walking-based activity/participation set at baseline with assessor and child/parent, and re-evaluated by child/parent at post-intervention assessments | 7 days pre/7days post/4-months post training intervention | |
Secondary | Change from baseline in targeted goal abilities as measured by Goal Attainment Scaling (GAS) | Three to five individualized walking-based activity/participation set at baseline with assessor and child/parent, and re-evaluated by child/parent at post-intervention assessments | 7 days pre/7days post/4-months post training intervention |
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