Effect of Task Specific Electrical Stimulation on Upper Limb Gross Motor Skills in Children With Spastic Quadriplegia
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Improved upper limb gross motor skills
研究概览
简要总结
Cerebral palsy is a non-progressive lesion of the brain occurring before 2 years of age resulting in disorders of posture and movement.( Ostensjo S, 2004)( Keles MN, 2018). Although non- progressive, motor impairments develop as the child grows leading to activity and participation restriction.
For children with CP, body function and structure impairments include changes in muscle tone and strength that affect the ability to control movement, specifically in regard to postural responses, selective control, regulation of activity, ability to learn unique movements, and inappropriate sequencing.(Ross SA,2007)( Ostensjo S, 2004) .
Lack of proper loading and maladaptive muscle pulls over time causes the skeletal system to adapt to positions of malalignment, malformation, and overall bone weakness (Beckung E, 2007) (Elbasan B, 2018).
These changes lead to delays in the natural progression of gross motor skills. As the child falls behind in motor function, they also fall behind in cognitive stimulation and development.( Akaya KU, 2018) . Understanding the anatomical and physiological implications that CP has on the developing child is necessary for physical therapists to treat this population, especially when utilizing electrical stimulation.
Spastic quadriplegia Is a type of cerebral palsy that affects all four limbs and typically involves significant motor impairment. It results from brain damage that occurs before, during, or shortly after birth, affecting the areas of the brain responsible for movement and coordination.
Electrical stimulation is a mode of physical therapy that can be utilized in the treatment of various nerve and muscle injuries, in addition to patients with acute and chronic pain. It involves an electrical pulse applied to a muscle or nerve that activates excitable tissue utilizing internal or external electrodes to build muscle strength, reduce pain, as well as create or support limb movement (Kerr C, 2007).
Task-specific electrical stimulation (TASES) is a therapeutic technique used primarily in rehabilitation settings to enhance motor function. The primary aim of TASES is to facilitate movement and improve motor learning by applying electrical stimulation to specific muscles during targeted tasks.
详细描述
Cerebral palsy is a group of non-progressive motor disorders; it commonly appears in early childhood and affects muscle tone, posture, and movement. (Salazar AP, 2019) The most common cause of physical disability in developed countries and one of the most common causes of acquired physical disability in children is cerebral palsy (Surveillance of cerebral palsy in Europe, 2000). between 1.5 and 4 per 1000 live births, on average (Smithers-Sheedy H, 2016).An estimated 17 million people live with cerebral palsy worldwide, and at least 80 percent of them will survive into their sixth decade ( Blair E, 2019).
This definition acknowledged that there are numerous etiologies for cerebral palsy and that, although the movement and posture disorders are permanent, the motor impairments are frequently progressive.
Classification in CP uses different descriptors and may assess different aspects of the clinical manifestation such as topography of affected limbs, severity of movement impairment, or upper limb manual ability. For instance, regarding topographical classification, unilateral involve- ment of an arm and leg is termed hemiplegia, predomi- nant lower limb involvement is termed diplegia, and involvement of all limbs is termed quadriplegia (Shevell MI, 2010) (Stanley FJ,2000).
Tone abnormalities result from the area of the central nervous system that is damaged. Damage at the vestibulospinal and rubrospinal pathways of the spinal cord and associated central cortex of the brain, accounting for 80% of cases, results in spasticity, at the basal ganglia results in dyskinesia, at the cerebellum results in ataxia, or a mix of any of these.( Goodman CC, 2015) Damage to the cortex, can result in the topography presentations of monoplegia, hemiplegia, diplegia, or quadriplegia, and at the basal ganglia athetoid. ( Ko, N.2022)
Spastic quadriplegia is a type of cerebral palsy characterized by increased muscle tone and stiffness affecting all four limbs, often resulting in significant motor impairment. (Smith J, 2023)
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
Intervention study model Parallel assignment. The study will include thirty children with spastic quadriplegic CP of both sex. Their age will range from two to six years meeting the inclusion criteria will be randomly assigned to two experimental groups : First experimental group: children in this group will receive a designed physical therapy program, attending three sessions per week for three consecutive months. The duration of the session was one hour of the designed physical therapy program. Second experimental group: children in this group will receive the designed program plus the task specific electrical stimulation (TASES) for 20 minutes during the weight bearing exercises as push up , prone on hands on wedge and quadruped with weight shifting.
入排标准
- 年龄范围
- 2 Years 至 6 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Their age will be ranged from 2 to 6 years. Their grade of spasticity will be from 1+ to 2 according to Modified Ashworth scale (Baunsgaard etal., 2016). (APPENDIX II).
- •They will be on Level III and IV according to Gross Motor Functional Classification System (GMFCS) (Palisano et al., 2008).(APPENDIX III).
- •Parents/legals representatives consenting to their child's participation 5 - Diagnosed with Spastic Quadriplegic cerebral palsy
排除标准
- •Previous neurological or orthopedic surgery in the upperextremities.
- •Fixed deformity in the joints of upper limb. 3- Severe hearing and visual defect.
- •4-Irregular attendance at assessments or therapy sessions
结局指标
主要结局
Improved upper limb gross motor skills
时间窗: after 3 months of treatment
The Quality of Upper Extremity Skills Test (QUEST) is used by assessment of the weight bearing domain .
次要结局
- Improvement in joints range of motion(after 3 months of treatment)
研究者
Aalaa Farag Soliman
aalaa ahmed farrag
Kafrelsheikh University