Loading Gait in Spatic Cerebral Palsy

Study Overview
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Brief Summary
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The purpose of this study is to observe the behavior of kinematic variables in children with spastic hemiparetic cerebral palsy (SHCP), immediately after treadmill gait training with ankle loading. The children underwent a single treadmill training session with ankle loading. The kinematic parameters were assessed in three phases: before training (PRE); immediately after training (POST); and 5 minutes after the end of training (FOLLOW UP). The investigators hypothesized that the treadmill gait training with additional lower limb loading would be a disturbance capable of modifying the locomotor strategy of children with SHCP, by the increase in kinematic parameters in the swing phase of gait.

Official Title
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Immediate Effects of a Single Treadmill Gait Training Session With Additional Loading on Kinematic Gait Parameters in Children With Spastic Cerebral Palsy

Conditions
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Spastic Hemiplegic Cerebral Palsy

Intervention / Treatment
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* Other: Single treadmill gait training with additional loading


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Spastic Hemiparetic Cerebral Palsy; Being able to walk without an assistive device (levels I or II of the Gross Motor Function Classification System - GMFCS); Not having undergone muscle lengthening surgery within the previous year; Not having applied botulin toxin to the lower limbs or serial casting in the previous 6 months. Exclusion Criteria: Inability to understand simple commands to perform the training and evaluation; Inability to walk on the treadmill with or without load on the lower limbs; Presence of any physical pain or discomfort during the course of training.

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 13 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 Hemiparetic Cerebral Palsy<br>Single treadmill gait training with additional loading | Other: Single treadmill gait training with additional loading<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in kinematic gait parameters after treadmill trainning with ankles loading | Kinematic gait data were captured by Qualisys Track Manager 1.6.0.x - QTM software and exported to Visual3D processing software, to reconstruct the segments and create a biomechanical model. It was carried out in two stages: static and dynamic collection. The dynamic collection was performed while the children walked on the electric treadmill. The primary outcome measure was the following spatiotemporal variables at the POST phase: cadence (steps/min), stride length (m), paretic step length (m), stance time (%), swing time (%) paretic lower limb (PLL), double stance (%), symmetry ratio and stance/swing time ratio. With respect to angular variables, the following parameters was analysed: angular displacement (maximum flexion, maximum extension and range of motion) of the hip and knee were investigated (º). | Immediately after training with ankles loading (POST phase) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in kinematic gait parameters after five minutes of rest | Kinematic gait data were captured by Qualisys Track Manager 1.6.0.x - QTM software and exported to Visual3D processing software, to reconstruct the segments and create a biomechanical model. It was carried out in two stages: static and dynamic collection. The dynamic collection was performed while the children walked on the electric treadmill. The secundary outcome measure was the same spatiotemporal and angular variables investigated at the POST phase although in this condition they was analysed at FOLLOW UP phase. | After five minutes of rest (FOLLOW UP phase) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral palsy, Gait, Weight Bearing, Rehabilitation