Effect of Functional Power Training on Calf Muscle Length and Strength in Children With Spastic Paresis

Recruiting

• Conditions: Cerebral Palsy, Spastic
• Interventions: Other: Functional power training

• Registration Number: NCT05649930
• Lead Sponsor: Amsterdam UMC, location VUmc

Brief Summary

Spastic paresis (SP) is a common motor condition in children and is often caused by cerebral palsy. Skeletal muscles develop differently in children with SP due to brain damage in early development; muscle strength and muscle length are reduced compared to typically developing (TD) children. Especially, the calf muscles are affected, which particularly affects their ability to walk and to run, hindering participation in society. There are several treatments aimed to increase the range of motion of the joint by lengthening the muscle, for example botulinum toxin injections. However, these treatments can have a weakening effect on the muscle due to deconditioning from immobilization and due to paralysis.

In rehabilitation centers in the Netherlands functional power training (MegaPower) is offered to children with SP who want to walk and run better. It has been shown that this training improves calf muscle strength and performance during functional walking tests. However, the effect of MegaPower training on muscle morphology (i.a. muscle volume and length) is still unknown. Therefore, the aim of this study is to assess the effect of MegaPower training on the muscle morphology of the medial gastrocnemius in children with SP using 3D ultrasonography. It is expected that MegaPower training results in an increase of muscle volume as well as elongation of the muscle belly. Muscle volume could increase due to hypertrophy of the muscle fibers induced by the training, which could elongate the muscle belly length due to the pennate structure of the medial gastrocnemius. A double-baseline design will be applied for this study with three different measurement times (T0-T1-T2) to compare the training period (12 weeks) with a period (12 weeks) of usual care.

Detailed Description

Not available

Study Timeline

• Study Start: 2022-06-20
• Study First Submitted: 2022-11-07
• Study First Submitted QC: 2022-12-05
• Study First Posted: 2022-12-14
• Status Verified: 2025-01
• Last Update Submitted: 2025-01-06
• Last Update Posted: 2025-01-08
• Primary Completion: 2025-04-30
• Study Completion: 2025-09-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 23

Inclusion Criteria

• Gross Motor Function Classification System I-III
• Children should be able to lie on their stomach for min. one minute
• Children should be able to follow instructions.

Exclusion Criteria

• Received (one of) the following interventions within six months:
• Casting
• Botulinum toxin type-A injections
• Orthopedic surgery.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Spastic paresis	Functional power training	Children with spastic paresis

Primary Outcome Measures

Name	Time	Method
Muscle belly length in mm	At the end of the training (week 12)
Tendon length in mm	At the end of the training (week 12)
Muscle volume in dm^3	At the end of the training (week 12)
Fascicle length in mm	At the end of the training (week 12)

Secondary Outcome Measures

Name	Time	Method
Isometric muscle strength of the medial gastrocnemius	At the end of the training (week 12)	Measured with a hand-held dynamometer in Nm.
10m Shuttle run test	At the end of the training (week 12)	Measured in amount of steps reached.
Dynamic muscle strength	At the end of the training (week 12)	Standing heel-rise test on one leg. Measured in amount of repetitions.
Ankle range of motion	At the end of the training (week 12)	Maximal dorsiflexion in degrees manually measured with a goniometer.
Body length in m	At the end of the training (week 12)
1-minute-walk-test	At the end of the training (week 12)	Distance (m) covered in 1 min walking.
6x15m sprint	At the end of the training (week 12)	Measured as average time (s) over 6x15 m sprint.
Body weight in kg	At the end of the training (week 12)
Functional Strength Measure (FSM)	At the end of the training (week 12)	Measurement for lower and upper limb functionality.
Lower leg length in mm	At the end of the training (week 12)	Measured from the lateral malleolus and tibial plateau.

Trial Locations

Locations (1)

Reade; 🇳🇱 Amsterdam, Netherlands