Vestibular and Motor Functions in Children With Hemiplegic Cerebral Palsy

Study Overview
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Brief Summary
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As many researches have been conducted to see the effects of vestibular system activation on gross motor activities of children with cerebral palsy but there are limited researches on improvement of motor abilities of hemiplegic cerebral palsy child using UEU or BOSU ball or treadmill in a single study. There is lack of research on vestibular stimulation in hemiplegic cerebral palsy along with neurodevelopmental treatment. This study will improve the gross motor activities of children with hemiplegic cerebral palsy. It will broaden up the ways for physical therapist to deal with this type of cerebral palsy (hemiplegic).

Detailed Description
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There are various therapeutic approaches that are used to improve motor activities and postural control in CP child. Among these approaches vestibular stimulation is used to improve neuromotor development by different sensory stimulation techniques. It has shown positive effects on motor control of CP child. It also influences all sensory experiences and is an exercise based approach.

Official Title
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The Effect of Vestibular Stimulation Along With Neurodevelopmental Technique on Motor Functions of Children With Hemiplegic Cerebral Palsy

Conditions
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Cerebral Palsy, Hemiplegic Cerebral Palsy

Intervention / Treatment
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* Other: Neurodevelopmental technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 3 years to 12 years Gender: Both Male and female Children with Spastic Hemiplegic CP scoring 1,1+ and 2 on Modified Ashworth scale Level III and IV on GMFCS (Gross Motor Function Classification System) Exclusion Criteria: Children with other types of Cerebral Palsy (diplegia, quadriplegia etc) Children with other Abnormalities and pathologies (delayed milestones, hydrocephalous, epilepsy etc) Children Undergone any kind of surgery (cardiac, shunt placement, orthopedic etc) Children with any other neurological deficits (spina bifida etc) Children with conditions in which vestibular stimulation is not allowed (paroxysmal positional vertigo or vestibular neuritis, Meniere's disease, migraine-associated vertigo, and childhood vertigo).

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 12 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group A<br>Neurodevelopmental Treatment. Total duration of treatment will be 20 minutes, 3 sessions per for 3 months | Other: Neurodevelopmental technique<br>* st month: postural maintenance; exercises with weight on forearms and hands, in sitting, crawling, semi-kneeling and standing positions with support from therapist. nd month: balance and corrective reactions; using CP ball and tilt board. rd month: ambulation training; appropriate to motor development level (crawling, creeping, walking in a semi-kneeling position and walking between parallel bars).<br>|
| Experimental: Group B<br>Neurodevelopmental Technique and Vestibular stimulation. Total duration of treatment will be 50 minutes (20 min NDT+ 30 MIN VS) 3 sessions per week for 3 months. | Other: Neurodevelopmental technique<br>* st month: postural maintenance; exercises with weight on forearms and hands, in sitting, crawling, semi-kneeling and standing positions with support from therapist. nd month: balance and corrective reactions; using CP ball and tilt board. rd month: ambulation training; appropriate to motor development level (crawling, creeping, walking in a semi-kneeling position and walking between parallel bars).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| GMFM-88 | It is a Standardized Observational Instrument designed and validated to measure change in gross motor function over time in children with Cerebral Palsy. The GMFM-88 item scores can be summed to calculate raw and percent scores for each of the five GMFM dimensions of interest, selected goal areas and a total GMFM-88 score. | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Ashworth Scale | The purpose of the Modified Ashworth Scale is to measure spasticity in patients who have lesions of the CNS or neurological disorders. The MAS is a quick and easy measure that can assist a clinician's assessment of spasticity during passive soft-tissue stretching. | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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motor activity, spasticity, vestibular stimulation