Clinical trial NCT06598657: Talocrural Mobilization With Movement in Spastic Cerebral Palsy
Official title: Effects of Talocrural Joint Mobilization With Movement in Spastic Cerebral Palsy Patients
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Spastic Cerebral Palsy (sCP)
Keywords: Talocrural joint
Mobilization with Movement
Spasticity cerebral palsy
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-09-19
Enrollment: 40
Sex: ALL
Minimum age (years): 8
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this randomized controlled trial is to find the effect of Mulligan's Mobilization with Movement of Talocrural joint in Cerebral Palsy Patients having spasticity on improving Ankle Range of Motion, improving balance and its effect on Gait speed.

Detailed description: Cerebral palsy is a neurodevelopmental disorder involving abnormalities in muscle tone and motor function due to damaged cerebral tissue in development. It is a nonprogressive upper motor neuron lesion characterized by abnormal tone, posture, balance and movement and clinically classified based on the predominant motor syndrome. In spastic CP, there is significant weakness that contributes to abnormal posture and movement. This is also accompanied by decreased muscle endurance and loss of selective motor control (SMC). Spastic diplegia is a very common form of CP, with a wide range of ambulatory outcomes, and is most frequently accompanied by ankle spasticity. Abnormalities, such as excessive plantar flexion of the ankle, leads to individuals with CP have in both static and dynamic balance.

Joint mobilization has not only the mechanical effect of disrupting the contracture by direct movement of the joint area, but also stimulates mechanoreceptor activation when stretching occurs in the capsule and ankle ligaments.

The Mulligan Mobilization with movement (MWM) is a physical therapy technique that combines joint mobilization techniques with active movement. It aims to improve joint range of motion, reduce stiffness, and enhance functional mobility, is expected to produce an instantaneous improvement in the patient's abilities by simultaneous applying of pain-free accessory glides.

This study will contribute in describing long lasting effects of Mobilization With Movement, with multiple assessments, on ankle range of motion, balance, and gait speed, and to check whether the amount of regaining is similar between patients undergoing MWM with conventional therapy and those with conventional therapy alone

Eligibility criteria: Inclusion Criteria:

* Both genders
* Age group 8-18 years
* Diagnosis of spastic Cerebral Palsy
* CP to follow verbal directions
* Modified Ashworth Scale score of '1' or '1+'
* Function classification system (GMFCS) level I or II ability to walk
* 10 m or more independently

Exclusion Criteria:

* visual, hearing disorders
* verbal and cognitive disorders (unable to comprehend commands)
* recent lower extremity surgery
* botulinum toxin injection

Primary outcomes:
measure: Time Up and Go
timeFrame: 4 weeks
measure: 10 m WALK TEST
timeFrame: 4 weeks
measure: Goniometer
timeFrame: 4 weeks
measure: Modified Ashworth Scale (MAS)
timeFrame: 4 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Islamabad
country: Pakistan
facility: PAF School for Persons With special Needs PNS, Islamabad
state: Punjab
Study officials:
affiliation: Riphah International University
name: KINZA ANWAR, MS-OMPT
role: PRINCIPAL_INVESTIGATOR
References: