NDT on Fall Risk in Cerebral Palsied Children

Study Overview
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Brief Summary
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Children with spastic cerebral palsy experience falls due to weakness in balance skills and abnormalities in gait parameters. It is necessary to improve the quality of life of these children by reducing the frequency of falling. Aim of this study was to investigate the effect of Neurodevelopmental Treatment on the risk of falling and balance and to contribute to the literature on this subject. Cases were randomized into study and control groups. At the beginning of the study, the balance skills of all the cases with spastic cerebral palsy were measured with the Pediatric Balance Scale, and the gait parameters and fall risks were measured with the LEGSys Temporospatial Gait Analysis Device. Then, an 8-week, case-specific, neurodevelopmental therapy program with intensive gait and balance training was applied to the study group in a 45-minute single session, 2 days a week. The control group received 8 weeks of conventional physiotherapy. At the end of the treatment process, the evaluations were repeated with the same methods.

Official Title
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Effect of Neurodevelopmental Treatment on Fall Risk and Balance in Children With Spastic Cerebral Palsy

Conditions
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Cerebral Palsy, Spastic, Falling

Intervention / Treatment
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* Other: Neurodevelopmental Therapy (NDT)
* Other: Conventional Physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cerebral Palsy diagnosis Spastic type Gross Motor Function Classification System Level I and II Exclusion Criteria: Tendon release surgery or Botox application in the last 6 months

Ages Eligible for Study
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Minimum Age: 2 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment Group<br>Treated with both the treatment programs determined on the basis of the NDT and conventional physiotherapy. Programs prepared specifically for each child, in a 45-minute single session, 2 days a week, for 8 weeks in total. Each child was given a treatment program tailored to their needs. | Other: Neurodevelopmental Therapy (NDT)<br>* In the treatment program; vestibular and proprioceptive training on the balance board; dynamic balance training in sitting with eyes open and closed, kneeling upright and standing; balance exercises in front of the mirror; standing on one leg with eyes open and closed to increase proprioceptive input; vestibular and proprioceptive training on exercise balls of the appropriate size; balance training on the trampoline; footpad sensory stimulation with different materials; weight-bearing training in sitting, crawling, kneeling and standing positions; functional reaching and throwing-holding exercises in different positions; multitasking pieces of training; gait exercises in various ways and training for climbing and descending stairs appropriate to the child's situation (assisted, unaided, symmetrical, reciprocal) took place.<br>Other: Conventional Physiotherapy<br>* Classical physiotherapy applications for balance.<br>|
| Active Comparator: Control Group<br>Treated with only the treatment programs determined on the basis of conventional physiotherapy. | Other: Conventional Physiotherapy<br>* Classical physiotherapy applications for balance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| LEGSys, Temporospatial Gait Analysis Device | Determining the patient's risk of falling by performing a kinetic analysis of the gait | Beginning of the study | 
| LEGSys, Temporospatial Gait Analysis Device | Determining the patient's risk of falling by performing a kinetic analysis of the gait | 8 weeks | 
| Pediatric Balance Scale (PBS) | Functional balance was assessed using PBS, which consists of fourteen tasks similar to activities of daily living. Higher scores indicate better balance. | Beginning of the study | 
| Pediatric Balance Scale (PBS) | Functional balance was assessed using PBS, which consists of fourteen tasks similar to activities of daily living. Higher scores indicate better balance. | 8 weeks |