Effects of Dynamic Wheelchair Seating on Spasticity and Functional Mobility in Children
Condition: Cerebral Palsy, Spastic
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      Cerebral palsy (CP) is a non-degenerative neuromuscular disease that can exist at or occur as
      a result of birth. Because of damage to one or more parts of the brain that control movement,
      an affected child cannot control his or her muscles normally. Prevalence of CP is similar
      worldwide, with pronounced severity in underdeveloped countries due to poor health and
      financial conditions.

      Research should be conducted to find methods of medical treatment to allow affected children
      to maintain or regain musculoskeletal functionality. Many children affected with CP spend
      much of their days restricted to a rigid wheelchair; limiting muscular and cognitive
      development, making it difficult to interact with their environment. The gap to be addressed
      by this study is to determine if a wheelchair that is based on the dynamics of human anatomy
      can allow enhanced function, while being adaptive to individual growth and development. At
      present, there is very little dynamic capability available in commercial wheelchairs to allow
      this mobility.

      A dynamic wheelchair system was recently designed and a small sample of able-bodied children
      has been tested in the chair. It is hypothesized that significant increases in functional
      mobility will be achieved in children with CP from the use of this novel wheelchair design.
    

Detailed description: 
      Specifically, it is expected that range of motion and functional mobility in the hip, knee,
      and ankle joints will increase, involuntary spasticity in the musculature of the mid and
      lower body will be reduced, and independent daily function will be enhanced in children with
      CP. The success of these conditions will greatly influence the child's interaction with the
      surrounding environment, maintaining neuromuscular function and providing enhanced mobility
      for coordinated development through childhood.

      This research will bring great benefits for children with CP, however children with other
      neuromuscular conditions should also benefit from the findings of this initial study.
      Specifically, the direct health benefits will include increased joint range of motion,
      reduction of spasticity, enhanced cognitive development and muscle coordination. The concept
      of this novel wheelchair design could be applied domestically within one year of project
      completion. If funded, this initial study will lead to a subsequent project of two years,
      which would focus on the feasibility of broadening the target population to include children
      in under-represented areas within the United States and in developing countries.

      Twenty children (4-12 years) with CP will be recruited for this study from the surrounding
      community and greater Rocky Mountain region. The study volunteers will be randomly assigned
      to either an experimental group (using new dynamic seating system), or a control group (using
      standard, state of the art non-dynamic chair systems). Consent will be obtained from each
      child and their parents/guardians. The study will consist of a pre-chair laboratory session,
      a supervised chair adaptation period (including a mid-way laboratory session) and a follow-up
      laboratory session. The pre-chair, mid-way and follow up laboratory sessions will consist of
      a series of cognitive/communicative, fine motor, and functional skill tests. Evaluation of
      these tests will be conducted by physical, occupational, and speech therapists. The
      wheelchair effect will be tested for significant improvement in joint range of motion, muscle
      spasticity and tone, and independent functionality.
    

Intervention name(s): Dynamic Wheelchair Seating System
Intervention type(s): Device
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment