跳至主要内容
临床试验/NCT06813599
NCT06813599尚未招募不适用

Effect of Motor Planning Exercises Versus Neurodevelopmental Technique on Gait Pattern in Children with Spastic Diplegic Cerebral Palsy

Kafrelsheikh University2 个研究点 分布在 1 个国家目标入组 30 人开始时间: 2025年3月1日最近更新:
适应症
干预措施

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
evaluate the progress of the COP throughout the foot support phase .

研究概览

简要总结

Cerebral palsy is the most common disability in childhood, is a devastating non-progressive ailment of the infants' brain with lifelong sequelae (e.g., spastic paresis, chronic pain, inability to walk, intellectual disability, behavioral disorders) for which there is no cure at present. Cerebral palsy has different causes such as perinatal asphyxia, stroke and central nervous system CNS infection.

Cerebral palsy may have several associated comorbidities, including epilepsy, musculoskeletal problems, intellectual disability, feeding difficulties, visual abnormalities, hearing abnormalities, and communication difficulties. There are different classifications of CP primarily based on motor type and topography one of them is diplegic CP, lower limbs are more seriously affected than the upper limb at times, patients have toe strolling because of a dorsiflexion problem of the foot and expansion in the tone of the lower leg. In serious cases, there is a flexion of the hips, knees and elbows, and when the child is held upward, the firmness of the lower furthest points is generally articulated and tightness of the adductor muscles of the lower legs cause scissoring of lower limits.

Neurodevelopmental therapy NDT is a popular approach to rehabilitation for people with cerebral palsy. It focuses on improving movement by analyzing how the body moves, understanding the relationship between posture and movement, and using sensory information to guide motor control. NDT therapists often use techniques like handling to facilitate movement and train people to use more typical motor patterns. While NDT has been widely used, there's ongoing debate about its effectiveness compared to other approaches, and its specific practices can vary across different countries and settings.

Motor planning is defined as either an explicit decision-making or implicit process that takes into consideration both the goal and the constraints of the desired movement . This process is thought to rely on a feedforward internal model based on action simulation . Before a motor command is sent, the system briefly perceives the environmental cues to anticipate the realization of an adapted movement . Through the representation of the sensorimotor associations learned from past experiences, a prediction of the sensory consequences of the action is made . This step appears before action initiation and is believed to be based on the copy of the motor command for a subset of tasks .

Motor planning is a large concept encompassing terms such as anticipatory control, motor preparation, and motor programming, with the terminology changing over time and varying by field of study.

Motor Planning Organization of Motor Actions Motor planning is the ability to automatically organize a motor act so that it can be performed or implemented. This involves the internal process of organizing one's motor actions, without consciously planning out the action is believed to be largely dependent on tactile proprioceptive sensory inputs, although visual perceptual and visual spatial skills are also often associated with this area of function. Most often, problems in motor planning are reflected in difficulties in planning body movements.

详细描述

CP is a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.

CP describes a group of permanent disorders of movement and posture, causing activity limitation, that are attributed to non progressive disturbances that occurred in the developing fetal or immature brain. The motor disorders of CP are often accompanied by disturbances of sensation, perception, cognition, communication, and behavior, by epilepsy, and by secondary musculoskeletal problems.

Spastic CP is described by which parts of the body are affected:

Spastic diplegia In this type of CP, spasticity is mainly in the legs, with the arms less affected or not affected at all. People with spastic diplegia might have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward, and cross at the knees also known as scissoring.

Spastic hemiplegia Hemiplegia affects only one side of body, usually the arm is more affected than the leg.

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

入排标准

年龄范围
3 Years 至 14 Years(Child)
性别
All
接受健康志愿者
否

入选标准

  • •Parents/legals representatives consenting to their child's participation
  • •Diagnosis of cerebral palsy
  • •Ages 3-14 years - Cooperative behavior
  • •Their grade of spasticity will be from 1 to 2 according to Modified Ashworth scale
  • •They will be on Level I and II according to Gross Motor Functional Classification System
  • •The child will be able to follow verbal commands and instructions.

排除标准

  • •The children will be excluded if they have one of the following:
  • •Previous neurological or orthopedic surgery in the lower extremities.
  • •Botox injection in the lower extremities in the past 6 months.
  • •Fixed deformity in the joints of lower limb.
  • •Severe hearing and visual problems.
  • •Different diagnosis than cerebral palsy.
  • •Inability to "walk freely or with a mobility aid (GMFCS Level IV or V)" .
  • •Irregular attendance at assessments or therapy sessions.

研究组 & 干预措施

group (A)

Experimental

Each child of group A received a designed NDT program, attending three sessions per week for two consecutive months. The internationally recognized neurodevelopmental therapy (NDT) intervention will be used, consisting chiefly of three components.

干预措施: Neurodevelopmental Technique on Gait Pattern in Children With Spastic Diplegic Cerebral Palsy (Other)

group (B)

Experimental

Each child of group B will receive a designed motor planning program, attending three sessions per week for two consecutive months.

Practicing skills will help children with poor motor planning ability become more confident. There are many things we can do to help children improve their motor planning.

干预措施: Motor Planning Exercises on Gait Pattern in Children With Spastic Diplegic Cerebral Palsy (Other)

结局指标

主要结局

evaluate the progress of the COP throughout the foot support phase .

时间窗: after 2 months of treatment

GAIT LINE IN DYNAMIC ANALYSIS evaluate the progress of the COP throughout the foot support phase.

change of space-time parameters of walking

时间窗: after 2 months of treatment

GAIT CYCLE IN DYNAMIC ANALYSIS change of space-time parameters of walking

change of pressure distribution

时间窗: after 2 months of treatment

Visualization of the footprint to analyze the change of pressure distribution

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Ahmed Mohamed Elsayed Sharaf

Demonstrator at faculty of physical therapy Rashid University

Kafrelsheikh University

研究点 (2)

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