Cognitive and Motor Training in Pediatric Posterior Fossa Tumor Survivors
Condition: Childhood Cancer; Cognitive Impairment; Motor Skills Disorders; Posterior Fossa Tumor
MeSH terms: Infratentorial Neoplasms; Motor Skills Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to create a rehabilitation program for children who survived
      posterior fossa tumors using the latest technology. Supposed that training in Fitlight,
      Dynavision D2, NeuroTracker will improve executive functions, visual-motor integration, fine
      and gross motor functions.
    

Detailed description: 
      The death rates from posterior fossa tumors (PFT) have declined significantly over the past
      decades. Children and adolescents who survived this kind of tumor without metastases
      demonstrate 5-year survival rates of 90%. Standard treatment for posterior fossa tumors
      includes surgical rejection, which can be combined with radiotherapy and chemotherapy.
      However, treatment factors can cause the impairment of motor and cognitive functions, which
      influence negatively speech, academic achievements, and quality of life. Such an outcome can
      be induced by tumor growth process as well. One of the most essential consequences of the
      disease is cognitive deficiency in the areas of attention, working memory, and executive
      functions.

      The cerebellum pathology often causes deficits of motor skills. Considering that motor system
      has a hierarchal organization, PFT can cause the impairment of all the system, starting with
      gross motor skills and ending in the finest eye movements. The cerebellum has been shown to
      control voluntary eye movements, particularly such parameters as accuracy and velocity of
      saccades, fixation duration, etc.

      Given the effect of probable deficits on a child's daily life, the issue of cognitive and
      motor remediation programs is in the spotlight today. There is some evidence that
      interventions targeting cognitive functions (e.g. working memory, short-term memory,
      attention, planning) and motor skills (gross and fine motor skills, muscle strength, agility)
      can be effective in these patients.

      However, only few of remediation programs focus on visual-motor co-ordination and saccadic
      eye movements system, despite the fact that they provide the basis for higher-level
      functions, such as sustained attention, working memory, and planning.

      The research conducted in Clinical Rehabilitation Research Center "Russkoe Pole" has revealed
      that treatment gains in the areas of motor skills, and specifically saccadic eye movements,
      are positively associated with the enhancement of attention and working memory. Given this,
      the investigators can suggest that this improvement is connected with the reduction of extra
      saccadic movements and consequently the decrease of irrelevant information to be processed.
      This mechanism can be generalized to the other executive functions, such as shifting,
      inhibition, and planning.

      This trial will allow the investigators to determine potential feasibility of rehabilitation
      program targeting motor and cognitive functions, as well as the saccadic system, in pediatric
      posterior fossa tumor survivors.
    

Intervention name(s): Cognitive and Motor Training
Intervention type(s): Other
Intervention description(s): In the first phase of the trial, all participants (patients and healthy children) will complete cognitive and motor functions assessment.
Then the sample of patients who have cognitive/motor impairment will be randomized to an either Intervention or Control group.
In the second phase of the trial, survivors in the Intervention Group will receive 6 sessions of cognitive and motor training during two weeks, and survivors in Control Group will undergo …..
After this treatment phase, motor and cognitive functions assessment will be conducted in all patients once again.
In the third phase, the Control Group will be provided the active intervention (i.e. 6 sessions of cognitive and motor training during two weeks), while the Intervention Group engages in passive reading.
After this, motor and cognitive functions assessment will be carried out in all patients once again.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: executive functions; motor skills; eye tracking; pediatric cancer; posterior fossa tumors