Physical Activity on Postural Stability and Coordination in Children With Posterior Fossa Tumor
Condition: Posterior Fossa Tumor; Medulloblastoma, Childhood
MeSH terms: Medulloblastoma; Infratentorial Neoplasms
Study type: Interventional

Summary: 
      Medulloblastoma is a rapidly-growing tumor of the cerebellum, this area controls balance,
      posture and sophisticated motor functions like finer hand movements, speech, and swallowing.
      It has been reported that those children fall frequently so the purpose of this study is to
      investigate the effectiveness of balance and coordination training in these Children.
    

Detailed description: 
      The effects of physical exercise training interventions for childhood cancer participants are
      not yet convincing due to small numbers of participants and insufficient study methodology.
      More and high-quality evidence is needed in order to be able to draft exercise and physical
      activity guidelines for this population. Despite the positive results of exercise
      interventions in adult cancer patients, the evidence for benefits in childhood cancer
      patients is limited.

      There are Two Main objectives:

        1. To investigate the effectiveness of Pilates core stability exercises program. 2. To
           investigate the effectiveness of Humac balance and tilt system.

      Secondary Objectives:

        1. The effectiveness of coordination training in children with posterior fossa tumors.

        2. The comparison between balance and coordination training and which of both trainings has
           more effect.

      This study will take place in a pediatric oncology setting, Children's Cancer Hospital
      Egypt(CCHE), in outpatient setting. Patients will be evaluated for their balance and
      coordination at initial presentation, during treatment, and during follow-up after end of
      treatment at CCHE. Also patients will receive balance and coordination training, before each
      chemotherapy cycle-maximum one week- given the patient is in good state.

      Sixty children with posterior fossa tumors of both sexes will participate in this study. They
      will be selected from CCHE. They will be randomly assigned into 3 groups of equal number.
    

Intervention name(s): Pilates Core Stability Exercises program; Balance Program; Coordination
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Twenty patients will receive Pilates core stability exercises program ONLY. Total Period: 12 Weeks
Stages: Three stages:
Stage I: Warm-up: consists of four Pilates motions:
Breathing:
Rolling back:
Coccyx-curl:
Hundred breathing:
Stage II: Work-out: consists of twelve Pilates motions:
Single leg stretch:
Straight leg raise:
Basic bridge:
Bridging variation:
Quadruped:
Clap with seal motion
Mermaid twist:
Swimming:
Double leg stretch:
Shoulder bridge:
Swan dive:
Leg full front:
Stage III: Cool-down: consists of three Pilates motions:
Rest position:
Cat with arm/leg extension:
Breathing:; Total Period: 12 Weeks. The designed HUMAC program will work on the modified clinical test of sensory integration of balance (mCTSIB) with eyes open and with eyes closed, the center of pressure (COP) and the limit of stability test (LOS).; Total Period: 12 Weeks. Coordination will be assessed using BOT2, Bilateral coordination (Sub test No.4) composed of 7 items and Upper-Limb coordination (Sub test No.7) composed of 7 items too.
The raw scores are recorded first then it is converted into point scores, then subtest total point score is obtained by adding point scores.
Other intervention name(s): HUMAC program
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Experimental controlled randomization using Block Stratified Randomized Software program, after obtaining informed consent from illegible patient or his caregiver.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: physical activity; postural stability; coordination; posterior fossa tumor