Cerebral Palsy Clinical Trial
Official title:
Comparison of Efficacy of Sensory Integration Therapy as an Adjunct to Standard Care With Standard Care Alone in Improving Gross Motor Skills in Cerebral Palsy Children With Sensory Processing Abnormalities
In this we are comparing efficacy of sensory integration therapy as an adjunct to standard care with standard care alone in improving gross motor skills in cerebral palsy children with sensory processing abnormalities.Existing literature points towards presence of sensory processing abnormalities in children with cerebral palsy.However, there is lack of robust evidence for usefulness of sensory integration therapy in cerebral palsy children .Standard therapy outcome in improving functional motor skills, adaptive responses are variable in children with cerebral palsy.Sensory integration therapy in addition to standard therapy may further improve adaptive and functional motor skills in children with cerebral palsy.
- Study will be started after obtaining ethical clearance and registration with Clinical
trials registry of India
- Hindi translation of SPCQ-2(Sensory profile caregiver questionnaire 2) by subject expert
by forward and independent backward translation .
- Consecutive children of either sexes between 3-12 years with a clinical diagnosis of
spastic cerebral palsy will be examined by the investigator and those having sensory
abnormalities as screened by Sensory profile caregiver questionnaire 2 will be included
in the study group.
- Those children who screen positive for sensory abnormalities fulfilling the inclusion
criteria would be enrolled in the study after obtaining informed consent from the
parents or guardian.
- Once enrolled children would be randomized into 2 groups , using a computer generated
random number sequence, an interventional group receiving sensory integration therapy
along with standard therapy and a group receiving standard therapy alone.
- Concealment of the random allocation would be ensured by placing the allocation sequence
in serially numbered, tamper proof, opaque and sealed envelopes(by a person other than
primary investigator to ensure blinding and further observation bias)
- Post - enrollment - Baseline clinical and demographic data will be recorded along with
associated co morbidities (maladaptive behavior, sensory deficits and motor problems).
- Pre-intervention a baseline motor skill will be obtained using Gross Motor Function
Measure -88 and behavioral assessment would be done using Child Behaviour Checklist
within 7 days of starting therapy in both arms (by pediatric neurologist ,child
psychologist respectively and who is unaware of the randomization and allocation to both
arms to prevent observer bias).
- Pre-intervention investigator would also interact with the parents or the primary care
giver and record parent's assessment of severity of sensory abnormalities in 5 main
domains - auditory , visual, tactile, proprioceptive and vestibular senses on a 10 item
Likert scale and also assess Quality of life using Pediatric Quality of life using
Pediatric Quality of life scale
- All children would be followed at set intervals from initiation of therapy as noted
below ;
- Weekly for 2 weeks then fortnightly for next 10 weeks to ensure proper technique and
compliance.
- At 3 months the blinded outcome assessor and child psychologist will re evaluate the
enrolled candidate to determine for any change by using Gross Motor Function Measure -88
, 10 item parent rated Likert scale, Child Behaviour Checklist and Pediatric Quality of
life as compared to baseline within 7 days of completion of therapy in both arms
The first visit would be primarily aimed at reinforcing the techniques of therapy and
clarifying parent's doubts. At 3 month visit child would be evaluated and re-assessed using
the scores- 10 item Likert scale rated by parents, Gross Motor Function Measure -88 and
Pediatric Quality of life scale . Parents would be encouraged to bring one random home video
of child doing activity-based therapy at 2 weeks wherever feasible . The video would be used
for ,
- Assessing the correct technique
- Suggesting modifications in the activity schedule if required
- Helps in ensuring adherence to technique
Compliance would be ensured by the
- Activity log
- Telephonic re-enforcement from the primary investigator weekly
;
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