Analyzing the Effect of Trunk Training on Limbs in Children With Spastic Cerebral Palsy

Study Overview
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Brief Summary
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The purpose of this study is to analyze if trunk training has effects on trunk, upper, lower extremity motor functions in children with spastic Cerebral Palsy. Second purpose is to analyze the relation between trunk control and prematurity, birth weight, upper and lower extremity motor functions in children with spastic Cerebral Palsy.

Detailed Description
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Cerebral Palsy (CP) is a condition caused by a lesion occurred in immature brain during prenatal, natal or postnatal period. Children with CP may have motor, cognitive, sensory, auditory, behavioral problems during their lifespan. Spastic type CP is most common type of CP and many children with spastic CP have both trunk and limb impairment. Physiotherapy is very important for improving motor function and protect from secondary impairments in this children and should start as early as possible. The aim of this study is to analyze if trunk training has effects on trunk, upper and lower extremity motor function in children with spastic CP. 38 children with spastic CP between 4-18 years age are included in this study. Both genders are included. The Participants randomized according to their gross motor function classification system levels and their age. Before intervention all groups assessed with assessment tools which assess muscle spasticity, balance, gross motor function, trunk control and walking characteristics. After randomization there wasn't any intervention for control group; they continued their regular physiotherapy in special education centers two times a week. Study group received trunk training two times a week in addition to their regular physiotherapy in special education centers during 8 weeks. After 8 weeks all groups assessed with the same assessment tools.

Official Title
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Analyzing the Effect of Functional Trunk Training on Upper and Lower Limb Motor Function in Children With Spastic Cerebral Palsy

Conditions
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Cerebral Palsy, Spastic

Intervention / Treatment
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* Other: Functional Trunk Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children with spastic cerebral palsy effected bilaterally Between 4-18 years age Exclusion Criteria: Received orthopedic surgery during last 6 weeks Receive Botulinum Toxin injection during last 6 weeks Mentally retarded children with communication limitations Had epileptic seizures during last 12 moths -

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Functional Trunk Training Group<br>Functional Trunk Training which includes strengthening of trunk muscle and functional activities including trunk region. | Other: Functional Trunk Training<br>* The intervention includes neurodevelopment treatment, muscle strengthening and functional activities of trunk region<br>|
| No Intervention: Control Group<br>No intervention, the continued their regular physical therapy | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in trunk control over time assessed with Trunk Control Measurement Scale. | Assessing change in trunk control | At baseline and 8 weeks after baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in daily living activities and participation over time assessed with Child Health Questionary Parent Form 50. | Assessment of child's daily living activities and participation | At baseline and 8 weeks after baseline | 
| Change in muscle activation over time assessed with Surface Electromyography. | Assessment of muscle activation | At baseline and 8 weeks after baseline | 
| Change in muscle spasticity over time assessed with Modified Tardieu Scale. | Assessing muscle spasticity | At baseline and 8 weeks after baseline | 
| Change in gross motor function over time assessed with Gross Motor Function Measurement | Assessing gross motor function | At baseline and 8 weeks after baseline | 
| Change in upper extremity skills over time assessed with Quality of Upper Extremity Skills Test | Assessing upper extremity skills | At baseline and 8 weeks after baseline | 
| Change in loco motion over time assessed with Gillette Functional Assessment Scale | Assessing loco motion. | At baseline and 8 weeks after baseline | 
| Change in walking parameters over time assessed with Physicians Rating Scale | Assessing walking parameters | At baseline and 8 weeks after baseline | 
| Change in functional loco motion over time assessed with Timed Up and Go Test | Assessing functional loco motion | At baseline and 8 weeks after baseline | 
| Change in walking speed over time assessed with 1 Minute Walk Test | Assessing walking speed | At baseline and 8 weeks after baseline | 
| Change in balance over time assessed with Pediatric Balance Scale | Assessing balance | At baseline and 8 weeks after baseline | 
| Change in impact of having a disabled child on family over time assessed with Impact on Family Scale | Assessing impact on family to have a disabled child | At baseline and 8 weeks after baseline | 
| Change in independence level over time assessed with Functional Independence Measure for Kids | Assessing independence level | At baseline and 8 weeks after baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Trunk Training, Motor Function