Influence of Surface Characteristics of Gait Training on Gait Kinematics and Walking Capacity in Children With Diplegic CP

Study Overview
=================
Brief Summary
-----------------
Using challenging surfaces of gait training, which require constant adjustments of the body's movement patterns to maintain stability and provide different sensory and proprioceptive inputs to mimic real life situation is appropriate for children with CP. So, the purpose of the current study is to investigate the influence of surface characteristics of gait training on gait kinematics and walking capacity in children with diplegic CP.

Detailed Description
-----------------
The purpose of the study is to determine the influence of surface characteristics (different surfaces materials and textures) of gait training on kinematics gait parameters (step length, step width, double support time and cadence) and the functional walking capacity in children with diplegic CP.

Official Title
-----------------
Influence of Surface Characteristics of Gait Training on Gait Kinematics and Walking Capacity in Children With Diplegic Cerebral Palsy

Conditions
-----------------
Diplegic Cerebral Palsy

Intervention / Treatment
-----------------
* Other: different walking surfaces
* Other: traditional gait training over hard surface only


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Their ages will range from 6 to 8 years old. The degree of spasticity will range from grade 1 or 1+ according to Modified Ashworth Scale. They will be at level II on GMFCS . They will be able to follow verbal command or instructions. Exclusion Criteria: 1. Fixed deformities of lower limbs. 2. Sever visual or auditory problems. 3. History of surgical interference in lower limbs less than one year. 4. Botulinum toxin injections to the lower limb during the previous 4 months.

Ages Eligible for Study
-----------------
Minimum Age: 6 Years
Maximum Age: 8 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: traditional physical therapy + gait training on different surfaces.<br>Children in study group will receive designed physical therapy program in addition to gait training on different surfaces. | Other: different walking surfaces<br>* different surfaces materials and textures as sand ,grass, air mattress , foam mattress ,gravels and Rollator<br>|
| Experimental: traditional physical therapy + traditional gait training<br>-Children in control group will receive designed physical therapy program in addition to traditional gait training hard surface . | Other: traditional gait training over hard surface only<br>* The children will receive gait training over hard surface and even ground only and bare feet without wearing any foot ware or orthosis<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| kinematics gait parameters | step length | over 3 months | 
| kinematics gait parameters | step width | over 3 months | 
| kinematics gait parameters | double support time | over 3 months | 
| kinematics gait parameters | cadence | over 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Six-minute walking test | The 6-minute walk test (6MWT) is self-paced walking test commonly used to assess functional capacity in children with CP. It can be easily applied in clinical sitting; it reflects functional capacity in terms of activities of daily living | over 3 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
CP , Diplegia