Intensive Goal Training for Adolescents With Cerebral Palsy

Study Overview
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Brief Summary
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Adolescents with cerebral palsy (CP) present important limitations for the performance of daily living activities. The aims of the study is to evaluate the feasibility and effects of an intensive goal training protocol for adolescents with CP. He hypothesize that adolescents submitted to the studied protocol will present improvements in performance and satisfaction of prioritized functional goals.

Detailed Description
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We will conduct a feasibility study to assess the implementation and the possible effects of an intensive individualized goal training with adolescents with CP. Adolescents will select up to 5 functional goals to be trained during a 2 weeks, 3 hour-daily training, totalling 30 hours across 2 weeks. Moreover, they will be asked to daily practice these activities at home along the intervention period.

Official Title
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Intensive Training of Functional Priorities Reported by Adolescents With Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Intensive goal training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medical diagnosis of bilateral CP; Age between 12 and 17 years old; Manual Ability Classification System (MACS) ranging from levels I to III; Gross Motor Function Classification System (GMFCS) ranging from levels I to IV; Ability to understand verbal instructions. Exclusion Criteria: Botulinum toxin or surgery in upper limbs in the previous 6 months of the study.

Ages Eligible for Study
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Minimum Age: 12 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
Interventional Model Description: Individualized intensive training of functional priorities presented by adolescents with CP. The intervention will happen during 2 weeks, 5 days/week, during 3 hours in a local rehabilitation center. Trained occupational and physical therapists will conduct the intervention procedures
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Intensive goal training of relevant activities reported by adolescents in the beginning of the study. Therapists will grade the level of complexity of the proposed activities, considering the relevant movements, task demands and contextual factors involved in the performance of each task. Adolescents will be asked to practice these activities at home (1 hour/daily) and to discuss their difficulties and improvements with the therapists. The intervention will be provided in a day-camp model. | Other: Intensive goal training<br>* Intensive goal training : 30 hours during 2 weeks<br>* Other names: intensive individualized functional training;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Functional Goals | Canadian Occupational Performance Measure (COPM) (ranging 1-10; higher values, better outcomes) | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 
| Change in Daily functioning- Self-Care | Pediatric Evaluation Disability Inventory (PEDI) self-care: ranging from 0-63; higher values, better outcomes | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 
| Change in Daily functioning- Mobility | Pediatric Evaluation Disability Inventory (PEDI) mobility: ranging from 0-55; higher values, better outcomes | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Manual dexterity | Box & Blocks Test (BBT)- number of blocks that are transported during 1 minute (there is no established max-min, higher values, better outcome) | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 
| Change in Gross motor function | Gross Motor Function Measure (GMFM): gross motor function abilities assessed in activities from 5 domains: lying and rolling; seating; crawling and kneeling; standing; walking, running and jumping. higher scores, better outcome | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 
| Change in Participation at home | Participation Environment Measure: Children and Youth (PEM-CY): Structured questionnaire to assess the frequency and level of involvement in daily living tasks (home scale will be used) higher scores, better outcomes | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up | 
| Change in Participation in household activities | Children´s Helping Out: Responsibility, Expectations and Supports (CHORES): structured questionnaire to assess the frequency and level of assistance in household activities: higher scores, better outcomes | 1 month before intervention; pre-intervention; immediate post-intervention, 3-month follow-up |