Effects of Dynamic Compression Garments in Children With CP

Study Overview
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Brief Summary
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In recent years, it is seen that dynamic compression garments are used to increase body stability and to provide tone regulation. Dynamic compression garments are used to apply pressure to specific muscles or muscle groups. Different studies have drawn attention to the effect of dynamic compression garments on postural control and proximal stability. Researchers observed that upper extremity functions and fine motor skills improved with the use of clothing, and they associated this with improved proximal stability. In light of this information, the aim of this study is; To investigate the effects of dynamic compression garments applied in addition to traditional treatment on posture, trunk control, and upper extremity functions during sitting in children with hemiparetic CP.

Detailed Description
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Cerebral palsy (CP) is a group of permanent neurodevelopmental disorders in the development of movement and posture, non-progressive, resulting in activity limitations, resulting from an injury to the developing brain. Children with CP who have problems in sensorimotor coordination due to decreased muscle strength and impaired sensory processing experience postural control problems. In hemiparetic CP, deterioration in the upper extremities affects children's daily living activities such as eating, dressing, undressing, combing hair, brushing teeth, self-care skills, functional independence, and quality of life. Since the trunk plays a very important role in postural control and extremity functions, providing trunk stability and thus effective use of the extremities is one of the important goals of physiotherapy.

Official Title
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Effects of Dynamic Compression Garments on Posture, Trunk Control and Upper Extremity Functions in Children With Hemiparetic CP

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Dynamic compression garments
* Other: Standard therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being diagnosed with congenital spastic hemiparetic cerebral palsy, To be between the ages of 4-18 To be at the level of I, II or III according to the Manual Ability Classification System Having sufficient communication skills The willingness of the family and the child to be included in the study Exclusion Criteria: The family's refusal to participate in the study Botulinum toxin application to the upper extremity or having undergone upper extremity surgery in the last 6 months Having behavioral and communication problems that hinder the practices to be carried out within the scope of the study Having an epileptic seizure

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: Study group<br>Dynamic compression garments for 2 hours a day in addition to standard therapy twice a week (1 session of 45 minutes) for a total of 6 weeks | Other: Dynamic compression garments<br>* Dynamic compression garments for 2 hours a day in addition to standard therapy twice a week (1 session of 45 minutes) for a total of 6 weeks<br>Other: Standard therapy<br>* Standard therapy twice a week (1 session of 45 minutes) for a total of 6 weeks<br>|
| Active Comparator: Control Group<br>Standard therapy twice a week (1 session of 45 minutes) for a total of 6 weeks | Other: Standard therapy<br>* Standard therapy twice a week (1 session of 45 minutes) for a total of 6 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Manual Ability Classification System | Individuals' manual dexterity will be classified according to Manual Ability Classification System before treatment. Manual Ability Classification System is a 5-level classification system developed to classify how children with cerebral palsy aged 4-18 use their hands while holding objects during activities of daily living. | 8 weeks | 
| Sitting Assessment Scale | It is a standard video-based observation tool designed for the assessment of sitting in children with cerebra palsy. The scale consists of five items: head control, trunk control, foot control, arm functions and hand functions and is evaluated as follows: 1= none; 2= weak; 3= reasonable; 4 = good. Minimum and maximum scores range from 5 to 20. | 8 weeks | 
| The Trunk Control Measurement Scale | The Trunk Control Measurement Scale measures two key components of trunk control during functional activities. For this reason, the scale consists of two parts: Static Sitting Balance and Dynamic Sitting Balance. The scale consists of 15 items in total. While the total score of the scale varies between 0-58 points, higher scores indicate a better performance. | 8 weeks | 
| Quality of Upper Extremity Skills Test | It is a test that evaluates the quality of movement and manual skills of children with cerebral palsy. It deals with how the child does the activity. It consists of 7 parts. The evaluator scores the test by observing how the child performs the desired movements. The increase in the score obtained from the test indicates the increase in the quality of upper extremity skills. | 8 weeks | 
| ABILHAND-Kids: a measure of manual ability | ABILHAND-Kids is a 21-item scale that evaluates bilateral hand use in activities of daily living in children with cerebral palsy. Each sub-item evaluates the difficulty level of children while performing the activity at three levels as impossible, difficult and easy. | 8 weeks | 
| Shriners Hospital Upper Extremity Evaluation | It is an upper extremity movement and function assessment tool based on video observation for children aged 3-18 years. It consists of 3 sub-sections: positional dynamic analysis, spontaneous functional analysis and catch-release function. | 8 weeks | 
| The Pediatric Evaluation of Disability Inventory | It is a scale used to evaluate changes in performance, functional skills and functional skills in children. It consists of 3 subsections. These; Functional skills, Caregiver level of help and Adaptations. Each division consists of the areas of self-care, mobility and social function. Functional skills subsection will be used in accordance with the purpose of our study. | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cerebral palsy, dynamic compression, postural control, trunk control, upper extremity function