Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05221307 |
| Other study ID # |
KSU4 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
May 15, 2022 |
| Est. completion date |
July 30, 2022 |
Study information
| Verified date |
August 2022 |
| Source |
Kahramanmaras Sutcu Imam University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Cerebral Palsy (CP) is a non-progressive neurodevelopmental disorder that starts in the early
stages of life, causes activity limitation, and consists of movement and posture
deficiencies. Children with CP usually have difficulties in mobility, transfer and social
participation due to many motor and sensory disorders such as muscle weakness, decreased
postural control, balance, spasticity. Core stability maintains posture and provides support
for extremity movements by connecting with the deep abdominal muscles, spine, pelvis and
shoulder girdle muscles. During reaching, walking and sudden perturbations in the body, the
Transversus Abdominus (TrAb) muscle is activated primarily than other trunk and extremity
muscles, creating a core stability. Core activity includes not only spinal stability and
power generation, but also many upper and lower extremity movements. By focusing on the TrAb
muscle with Pilates, the stabilization of the trunk muscles can be increased by creating
control thanks to the core stabilization training. In addition, the TrAb muscle works
together with the diaphragm muscle, which is the main respiratory muscle. The expected
increased respiratory capacity with training may also affect hemodynamic responses.
Description:
Children with CP usually have difficulties in mobility, transfer and social participation due
to many motor and sensory disorders such as muscle weakness, decreased postural control,
balance, spasticity. Abnormal motor patterns and tone, poor trunk control, and postural
disorders adversely affect the physical development of these children. Children with CP show
deficits in proximal muscle co-contraction and posture stabilization, which leads to
limitations in postural reactions and antigravity movements. Dysfunctions are also observed
in antisipatory and reactive postural adjustments, and limitations occur especially in upper
extremity functions such as walking, reaching, and eating. Although these limitations
associated with postural control dysfunctions are known, optimal intervention methods have
not yet been determined. Because of these dysfunctions, many individuals with CP have
difficulty walking independently, walking on slopes/uneven ground, and performing daily
physical functions. Trunk control, which is formed by the activation of the core muscles, is
the determinant of postural control, automatic postural reactions, balance, walking and
functional activities from the early period.By focusing on the TrAb muscle with Pilates, the
stabilization of the trunk muscles can be increased by creating control thanks to the core
stabilization training. In addition, the TrAb muscle works together with the diaphragm
muscle, which is the main respiratory muscle. The expected increased respiratory capacity
with training may also affect hemodynamic responses. Proximal extremity muscles around the
hip are also important for maintaining upright posture and maintaining mobility. Studies have
shown that hip abductor muscle strength is more associated with gait variables and motor
functions in children with CP compared to knee and ankle muscles. Although the importance of
this in terms of gait has been determined, studies investigating the activation patterns of
trunk and hip muscles during walking of individuals with CP are limited.For this reason, it
is thought that pilates training can be applied in terms of muscle strength and postural
control in selected individuals with CP who can walk, stand independently, but need to
develop some components for controlled movement.Although there are a limited number of
studies investigating the effects of modified pilates exercises (MPE) in individuals with CP
in different clinical types, their effects on trunk control, core muscle endurance,
hemodynamic responses and gait have not been investigated. It is known that most children
with CP have significantly lower performance in cardiorespiratory and metabolic tests than
their healthy peers.For many of these children, these mobility limitations associated with
physical activity adversely affect musculoskeletal and cardiovascular function and increase
the risk for secondary medical conditions. Therefore, viable, effective interventions are
needed to improve the mobility and cardiorespiratory performance of children with CP. For
example, bodyweight supported treadmill training has been used to address these children's
walking and fitness goals. However, its routine use in smaller clinics, schools and home
settings is often not feasible given the physical requirements associated with helping a
child with significant weakness, spasticity or cardiovascular endurance deficiencies keep
pace.For this purpose, it is noteworthy that the effects of MPE training targeting the TrAb
muscle on gait and hemodynamic responses have not been investigated, especially in children
with CP.This study aims to determine the effects of modified pilates exercises (MPE) and
traditional neurodevelopmental therapy (NDT-Bobath) on hemodynamic responses in children with
CP.
