Associated Disorders of Locomotion and Postural Control of Axial Segments in Cerebral Palsy
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cerebral Palsy, Spastic
- Sponsor
- Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
- Enrollment
- 17
- Locations
- 1
- Primary Endpoint
- Change of the peak of ankle negative power during the weight acceptance phase of gait
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Gait abnormalities, which occur in Cerebral Palsy (CP), are characterized usually by a toe-to-floor or a plantar-to-floor initial contact (equinus gait), followed by an early braking of the tibia's forward progression (during ankle dorsiflexion). This causes consequently a trunk deceleration. Moreover, children with CP have difficulties to stabilize the trunk and the head in the space, and that could have impact on gait. If equinus gait is often attributed to the triceps surae spasticity, recent works suggest rather that this early braking of the dorsiflexion could be a motor adaptation to axial postural control difficulties. This thesis project aims firstly to attest that locomotor disorders are related to these difficulties in the stabilization of the axial body segments in children with CP and, secondly, to show that improving the trunk and head postural control with a specific rehabilitation protocol could reduce the early braking of the dorsiflexion and, consequently, the gait abnormalities observed in CP.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Gross Motor Function Classification System I or II
- •no or minimal contracture of the triceps surae
- •presence of soleus spasticity
Exclusion Criteria
- •botulinum toxin injections or surgery in the lower limb respectively in the 6 and 12 months preceding the study
- •any modification of the physical or orthopaedic therapy within the last two months
- •minimal hip flexion above 20° in a clinical examination
- •pain in the lower legs when standing or walking
Outcomes
Primary Outcomes
Change of the peak of ankle negative power during the weight acceptance phase of gait
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
In watts per kg.
Change of the peak of trunk's anterior deceleration during the weight acceptance phase of gait
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
In m/s²
Change of the score of the Trunk Control Measurement Scale (TCMS)
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
Score from 0 to 58. The higher the score, the better the trunk control.
Change of the center of pressure sway area during unstable sitting posturography
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
In mm²
Change of the center of pressure velicoty during unstable sitting posturography
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
In mm²/s
Change of the peak of the center of mass downward deceleration during the weight acceptance phase of gait
Time Frame: Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation
In m/s²
Secondary Outcomes
- Change of the Dimensionless walking speed(Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation)
- Change of the center of pressure sway area during quiet standing(Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation)
- Change of the dimensionless step width(Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation)
- Change of the center of pressure velicoty during quiet standing(Change from baseline to the end of the first 3-months period of rehabilitation and from this latter to the end of the second 3-months period of rehabilitation)