Case Series_Targeted Training for Trunk Control Cerebral Palsy
- Conditions
- Cerebral Palsy
- Interventions
- Device: Targeted Training for trunk control
- Registration Number
- NCT02246751
- Lead Sponsor
- University of Hartford
- Brief Summary
Little is known about how children with cerebral palsy (CP) use their sensory systems (touch, sense of body position, balance organs in the inner ear, vision) to help them achieve trunk control for independent sitting. If a child with CP does not achieve trunk control by 4 years of age their prognosis for motor skill development including walking is poor. Clinical researchers at The Movement Centre in Oswestry, England have developed a method called Targeted Training in which children train trunk control in small segments from the top down using a custom fit training device. This study aims to examine how children with moderate to severe CP use sensory information for trunk control before, during and after a program of Targeted Training.
- Detailed Description
One of the major challenges of motor control is to understand how the central nervous system controls the degrees of freedom of the body. This is particularly evident in cerebral palsy (CP), which is the most prevalent chronic childhood motor disability and is one of the most disabling and costly chronic disorders of children and adults. Deficits in postural control and sensorimotor integration are hallmarks of CP. Although postural control of the trunk for independent sitting creates the foundation for all other motor tasks, surprisingly little is known about how children with CP use sensory input to guide their development of upright control (which occurs in typically developing infants by 8 months of age). This lack of knowledge limits our ability to effectively assess and treat children with neuromotor deficits in trunk control.
The objectives of this project are to identify sensory reliance and sensory re-weighting in a study of children with moderate-to-severe CP (4-12 years of age) before and after Targeted Training for Trunk Control. A novel trunk support device will enable testing of participants who lack (or are still developing) stable sitting. In experiments, kinematics of the head and trunk will be measured. Sensory reliance and re-weighting will be identified from postural trunk responses to sensory conflict stimuli consisting of tilts of a visual surround and/or tilts of a surface which participants sit upon. Generally, participants with a high reliance on vestibular feedback will remain upright with respect to gravity during all tests; whereas a high reliance on cutaneous or visual feedback will produce trunk sway away from upright and toward the surface or visual surround tilt, respectively. To tease apart biomechanical, physical, and neurological contributions to trunk sway, sensorimotor integration modeling will be used to complement data interpretation.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 10
- cerebral palsy
- age 2-12 years
- Gross Motor Function Classification System (GMFCS) Level III, IV or V
- spinal fixation
- fixed scoliosis
- uncontrolled seizures
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Single subject design case series Targeted Training for trunk control Targeted Training for trunk control, 5-6 days a week for 9 months, minimum of 20 minutes per day.
- Primary Outcome Measures
Name Time Method Change in sensory motor processes 9 months and 1 and 3 months post training Change in sensory motor processes as evidenced by kinematic measures during sitting balance perturbation tasks.
- Secondary Outcome Measures
Name Time Method Change in gross motor functional skills (e.g. sitting, crawling, standing) 9 months and 1 & 3 months post training The Gross Motor Function Measure (GMFM 66) is a standardized test of gross motor function that has been validated for children with cerebral palsy
Segmental Assessment of Trunk Control 2, 4, 6, 8 and 9 months and 1 & 3 months post training Change in the trunk segment where static, active or reactive control is lost.
Trial Locations
- Locations (1)
Pediatric Balance Laboratory; University of Hartford;
🇺🇸West Hartford, Connecticut, United States