Cerebral Palsy Clinical Trial
Official title:
Effectiveness of Interactive Computer Play on Trunk Control and Gross Motor Function in Children With Cerebral Palsy: a Pilot Randomized Controlled Trial
Verified date | August 2019 |
Source | The Hong Kong Polytechnic University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Objectives:
This proposal is to investigate the effect of a 6-week training programme using an
Interactive computer play (ICP) on the trunk control, balance and gross motor function in
children with cerebral palsy (CP).
Hypothesis to be tested:
The trunk control, balance and gross motor function of children with CP will be significantly
improved after the ICP programme.
Design and subjects:
20 children (6 to 12 years old) with CP will be recruited in this pilot randomised controlled
trial. The children will be randomly allocated into a control or treatment group (10 children
in each arm).
Study instruments:
Tymo is a wireless force plate used for assessment and training.
Intervention:
An ICP program will be set up using the Tymo. The child uses their trunk movements in the ICP
in sitting during the intervention. The children will receive the intervention 4 times/week,
20 minutes/session for 6 weeks. All children will be assessed at the beginning, 3, 6 and 12
weeks post-intervention.
Main outcome measures:
- Segmental Assessment on Trunk control
- Pediatric Reach Test
- Gross Motor Function Measure Item Set (GMFM IS)
- 2-minute walk test
Data analysis:
As a pilot study, 20 children will be recruited for this study. Independent t-test or Mann
Whitney U test will be used to compare the continuous and ordinal results between the
intervention and control groups.
Expected results:
The trunk control, balance and gross motor function of children with CP will be significantly
improved after the intervention.
Clinical significance and potential of the study:
This is clinical trial to examine the effectiveness of a new intervention, a kind of
interactive computer play training module, on training the trunk control for children with
cerebral palsy. If the intervention is proven effective, it may be an adjunct to the
conventional Physiotherapy to children with movement disorders in enhancing their trunk
control. Better trunk control will in turn improve the daily function for these children as
their sitting and standing balance is improved. In a long run, these children will not rely
on expensive seating equipment to maintain their balance during schooling and at home.
Status | Completed |
Enrollment | 18 |
Est. completion date | September 30, 2018 |
Est. primary completion date | September 30, 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 6 Years to 12 Years |
Eligibility |
Inclusion Criteria: 1. Children with a diagnosis of CP will be of GMFCS levels III to IV, who in general, require walking aid (level III) during ambulation and with limited walking ability (level IV).[4] Aiming to achieve a higher homogeneity of the recruited children, for those with level III, only those requiring physical assistance to climb stairs will be recruited and so it is believed that only those with lower motor ability, i.e. similar to level IV, will be included. 2. Children, with non-CP physical disabilities, will have similar gross motor function as in (1). 3. Aged from 6 to 12 years old and 4. Able to follow instructions to interact in simple computer games Exclusion Criteria: Children with epilepsy/ seizures that could be elicited by flashing lights or sudden loud noises from computer screens |
Country | Name | City | State |
---|---|---|---|
Hong Kong | The Hong Kong Polytechnic University | Hung Hom |
Lead Sponsor | Collaborator |
---|---|
The Hong Kong Polytechnic University | Manchester Metropolitan University |
Hong Kong,
Bañas BB, Gorgon EJ. Clinimetric properties of sitting balance measures for children with cerebral palsy: a systematic review. Phys Occup Ther Pediatr. 2014 Aug;34(3):313-34. doi: 10.3109/01942638.2014.881952. Epub 2014 Feb 3. Review. — View Citation
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Butler PB, Saavedra S, Sofranac M, Jarvis SE, Woollacott MH. Refinement, reliability, and validity of the segmental assessment of trunk control. Pediatr Phys Ther. 2010 Fall;22(3):246-57. doi: 10.1097/PEP.0b013e3181e69490. — View Citation
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Jelsma J, Pronk M, Ferguson G, Jelsma-Smit D. The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Dev Neurorehabil. 2013;16(1):27-37. doi: 10.3109/17518423.2012.711781. Epub 2012 Oct 3. — View Citation
Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol. 1992 Jun;34(6):547-51. — View Citation
Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013 Jun;55(6):509-19. doi: 10.1111/dmcn.12080. Epub 2013 Jan 24. Review. Erratum in: Dev Med Child Neurol. 2016 Mar;58(3):316. — View Citation
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Rachwani J, Santamaria V, Saavedra SL, Wood S, Porter F, Woollacott MH. Segmental trunk control acquisition and reaching in typically developing infants. Exp Brain Res. 2013 Jul;228(1):131-9. doi: 10.1007/s00221-013-3544-y. Epub 2013 May 17. — View Citation
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Sandlund M, McDonough S, Häger-Ross C. Interactive computer play in rehabilitation of children with sensorimotor disorders: a systematic review. Dev Med Child Neurol. 2009 Mar;51(3):173-9. doi: 10.1111/j.1469-8749.2008.03184.x. Epub 2009 Jan 26. Review. — View Citation
Sharan D, Ajeesh PS, Rameshkumar R, Mathankumar M, Paulina RJ, Manjula M. Virtual reality based therapy for post operative rehabilitation of children with cerebral palsy. Work. 2012;41 Suppl 1:3612-5. doi: 10.3233/WOR-2012-0667-3612. — View Citation
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* Note: There are 17 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Segmental Assessment on Trunk Control-static | assess the level of static segmental trunk control. Assessment score represents as follows: 1= learning head control, 2= learning upper thoracic control, 3= learning mid-thoracic control, 4= learning lower thoracic control, 5= learning at upper lumber control, 6= learning lower lumbar control, 7= learning full trunk control and 8= achieved full trunk control. | 12 weeks | |
Primary | Segmental Assessment on Trunk Control-active | assess the level of active segmental trunk control. Assessment score represents as follows: 1= learning head control, 2= learning upper thoracic control, 3= learning mid-thoracic control, 4= learning lower thoracic control, 5= learning at upper lumber control, 6= learning lower lumbar control, 7= learning full trunk control and 8= achieved full trunk control. | 12 weeks | |
Primary | Segmental Assessment on Trunk Control-reactive | assess the level of reactive segmental trunk control. Assessment score represents as follows: 1= learning head control, 2= learning upper thoracic control, 3= learning mid-thoracic control, 4= learning lower thoracic control, 5= learning at upper lumber control, 6= learning lower lumbar control, 7= learning full trunk control and 8= achieved full trunk control. | 12 weeks | |
Secondary | Pediatric Reach Test-forward Sitting | assess how far the child can reach forward in sitting | 12 weeks | |
Secondary | Pediatric Reach Test- Right Sitting | assess how far the child can reach to his/her right in sitting | 12 weeks | |
Secondary | Pediatric Reach Test- Left Sitting | assess how far the child can reach to his/her left in sitting | 12 weeks | |
Secondary | Pediatric Reach Test- Forward Standing | assess how far the child can reach forward in standing | 12 weeks | |
Secondary | Pediatric Reach Test- Right Standing | assess how far the child can reach to his/her right in standing | 12 weeks | |
Secondary | Pediatric Reach Test- Left Standing | assess how far the child can reach to his/her left in standing | 12 weeks | |
Secondary | Gross Motor Function Measure Item Set- Total Score | assess the gross motor function using Gross Motor Function Measure Item Set.There are 4 Item Sets: Item Set 1 includes 15 test items (score ranged from 0 to 45), Item Set 2 including 29 items (score ranged from 0 to 87), Item Set 3 including 39 items (score ranged from 0 to 117) and Item Set 4 including 22 test items (score ranged from 0 to 66). Each participant will only be assessed with 1 Item Set based on their score on pre-defined decision items (Russell et al.Gross Motor Function Measure (GMFM-66 & GMFM-88) User's manual 2nd Edition. 2013). Individual item scores of the Item Set are entered and a mathematical algorithm calculates an interval level total score ranged from 0 to 100) using the Gross Motor Ability Estimator (GMAE-2) Scoring Software (https://www.canchild.ca/en/resources/191-gross-motor-ability-estimator-gmae-2-scoring-software-for-the-gmfm). The higher scores mean higher abilities. | 12 weeks | |
Secondary | 2-minute Walk Test | measure how far the study participant can walk in 2 minutes in metres | 12 weeks | |
Secondary | Height | measure the height of study participants in centimetres | 12 weeks | |
Secondary | Weight | measure the body weight of study participants in kilograms | 12 weeks | |
Secondary | Gross Motor Function Measure 88- Lying | assess the gross motor function in lying and rolling using Gross Motor Function Measure 88-lying (score ranged from 0 to 51) where higher score means higher gross motor function in this position. | 12 weeks | |
Secondary | Gross Motor Function Measure 88- Sitting | assess the gross motor function inlsitting using Gross Motor Function Measure 88-sitting (score ranged from 0 to 60) where higher score means higher gross motor function in this position. | 12 weeks | |
Secondary | Gross Motor Function Measure 88- Crawling and Kneeling | assess the gross motor function in crawling position using Gross Motor Function Measure 88-crawling and kneeling (score ranged from 0 to 42) where higher score means higher gross motor function in this position. | 12 weeks | |
Secondary | Gross Motor Function Measure 88- Standing | assess the gross motor function in standing position using Gross Motor Function Measure 88-standing (score ranged from 0 to 39) where higher score means higher gross motor function in this position. | 12 weeks |
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