Seat Cushions Adaptations on Upper Extremity Function In Cerebral Palsy Children

Study Overview
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Brief Summary
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As the seating adaptations, ranging from simple to complex, standard and customized may facilitate optimal health and maximize functional participation despite limited postural control; the study will be conducted for determine the effect of contoured cushions as a seat adaptation on upper extremity function in children with spastic cerebral palsy and compare between the effect of flat cushion and contoured cushion in adaptive seating system on upper extremity function in children with spastic cerebral palsy.

Detailed Description
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As research continues to reveal the efficacy of ramped and contoured cushions on postural stability and alignment (Macdonald et al.,2015), it is likely that it will become accepted that such modifications will affect the UL functional level , mobility and rang of motion. Therefore, the purpose of this study was to examine the effect of contoured cushions as adaptive seating intervention on Upper extremity function in children with spastic cerebral palsy.

Official Title
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Effect of Different Seat Cushions Adaptation on Upper Extremity Function in Children With Spastic Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Device: seat cushions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Their age ranged from three to six years old . Spasticity ranged from 1+ to 2 grade according to Modified Ashwarth Scale . All children should be able to sit on the adaptive seat while head is upright independently and hands are free; preliminary test by Gross Motor Functional Measurement (GMFM) scale ranged score from ( 21 to 25 ) in sitting domain. Exclusion Criteria: Any child with the following criteria will be directly excluded from the evaluation for the consistency of the sample and statistically obtained results: Visual and/or auditory defects which interfere with upper extremity functions. Fixed deformity of one or both upper limbs which limit passive ROM in shoulder and elbow. Children with mixed type, dyskinetic or ataxic cerebral palsy are excluded. surgical intervention in both upper limbs or botulinum toxin injection in the last 6 months before the time of assessment . Any recent trauma of one or Both upper limbs.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 6 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: Spastic Cerebral Palsy<br>spastic Cerebral palsy children will be adapted in adaptive seat with flat and then Contoured cushions while kinematic changes of upper limb reaching movement are monitored through video capture with kinovea 2D software motion analysis system. | Device: seat cushions<br>* flat versus contoured customized seat cushions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Angular kinematic changes in Upper extremity rang of motion in parallel to functional changes will be addressed while seat adaptations( flat and contoured cushions) will be applied for same participant. | angular kinematic changes ( by degrees) will be measured by kinovea 2D software | within 30 to 60 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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seat cushions, upper extremity , cerebral palsy