Targeted Training for Trunk Control_case Series Cerebral Palsy

Study Overview
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Brief Summary
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If a child with cerebral palsy does not develop independent sitting balance by 4 years of age, their prognosis for walking is very poor. Surprisingly little is known about how to facilitate head control or upright sitting balance and functional mobility in the child who is not developing these skills. This is one of the first studies that will examine intermediate stages in the development of the postural control system in children with neurologic deficits. Clinical researchers at The Movement Centre in Oswestry, England have developed a method called Targeted Training in which trunk control is trained in children segment by segment using a specific training device. This study aims to examine kinematic and electromyographic changes in a case series of children who undergo a 6-month Targeted Training intervention.

Official Title
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Segmental Training for Trunk Control a Pilot Study for Children With Moderate to Severe Motor Impairment.

Conditions
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Cerebral Palsy, Traumatic Brain Injury

Intervention / Treatment
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* Device: Targeted Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: neurologic diagnosis that results in a deficit in trunk control (i.e. cerebral palsy, traumatic brain injury) age 4-17 years Gross Motor Function Classification System (GMFCS) level III, IV or V for children with cerebral palsy Exclusion Criteria: spinal fixation fixed scoliosis uncontrolled seizures

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 17 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Single subject case series<br>Targeted training, 5-6 days a week for 6 months, minimum of 20 minutes per day | Device: Targeted Training<br>* Custom training devices were imported from The Movement Centre for research purposes. The typical course of treatment involves loaning the customized equipment to each family for use in their home or in their child's educational setting. Training occurs once daily usually for 30-45 minutes. This is done 5 or 6 days per week. Training programs typically involve playing with balls or balloons or video games that motivate the child to hold the head erect and to wave the arms and hands and move the upper body.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Gross Motor Function Measure |  | 6 months and followup post training 12 months | 
| Probe data, balance | timed balance task | baseline, intervention, 2 months post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in head stability | Change in alignment and stability of head postural sway during quiet sitting | 6 months, 1,3, and 12 months post intervention | 
| Change in muscle activation strategy during quiet sitting with different levels of external support. |  | 6 months, 1 and 3 months post intervention | 
| Change in Pediatric Evaluation of Disability Inventory (PEDI) |  | 6 months and 1,3, 12 months post intervention | 
| Qualitative Parent, Teacher report |  | during intervention and post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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trunk segments, postural control, Targeted Training, cerebral palsy