Clinical trial NCT03954808: Motor Imagery Training in Children With Unilateral Cerebral Palsy
Official title: The Effect of Motor Imagery Training on Muscle Activity, Motor Imagery and Functional Movement Skills in Individuals Unilateral Cerebral Palsy
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cerebral Palsy
Keywords: Unilateral Cerebral Palsy, Motor imagery,
Lead sponsor: Abant Izzet Baysal University
Sponsor class: OTHER
First posted: 2019-05-17
Enrollment: 51
Sex: ALL
Minimum age (years): 7
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Motor imagery (MI) is a promising method to improve more cognitive aspects of motor behaviour, and may, thus, be effective for facilitating motor planning in children with Cerebral Palsy (CP). MI training facilitates the neural plasticity by enhancing the neuronal cortical pathways in brain. In children with CP, motor planning and MI capacity were found to be affected by studies. In the literature, there are studies about the evaluation of MI in Unilateral CP but there is insufficient number of studies included in MI in the rehabilitation program.

The aim of the study was to investigate the effect of motor imagery training for gait and lower extremity muscle activity (with EMG), functional capacity, quality of life, and time performance variables in Children with Unilateral CP.

The eligible participants will be allocated three groups, including motor imagery training group, traditional physiotherapy control group, and healthy control group. All the assessments will be performed before and after the training in the 8-week motor imagery training group and 6 weeks after the end of training. The participants in the control group will be evaluated with a 8-week interval and 6 weeks after the end of physiotherapy training. The healthy participants will be assessed only once. The motor imagery training will be designed for the individual basis with standard protocols. It will be applied two times a week for 8 weeks. All sessions will be performed in the clinic.

Detailed description: Unilateral CP and age matched healthy individuals will be participate the study between the ages of 7 and 18 years. Children's gross motor skills classified with GMFCS.

The control group individuals will be given a traditional physiotherapy two days per week for a total of 8 weeks (traditional physiotherapy session will last 45 minutes). Motor imagery training group will receive a traditional physiotherapy and motor imagery training within a specific program, two days a week for a total of 8 weeks (30 minutes traditional physiotherapy session+15 minutes MI training) .

Within the scope of MI training, individual training program will be determined by taking into consideration the needs of the individuals and the expectations for gait. The basic case of PETTLEP (Physical, Environment, Task, Timing, Learning, Emotion, Perspective) will be followed. MI training will be given individually with the same physiotherapist.

Eligibility criteria: Inclusion Criteria:

* Diagnosis of Cerebral Palsy voluntary participation
* Age between 7-18 years, Children with Unilateral Cerebral Palsy
* With suitable cognitive state for training
* To attend a formal school
* GMFCS Level I-II
* IQ\>70 Children with Unilateral Cerebral Palsy (from children's file)
* Mini-Mental State Exam For Children score above 24

Exclusion Criteria:

* Severe cognitive impairment and not able to follow task instructions
* IQ\<70 Children with Unilateral Cerebral Palsy (from children's file)
* Who received motor imagery training last 6 months
* Severe Vision and hearing problems
* Botox or surgeries in the last 6 months

Primary outcomes:
measure: Movement Imagery Questionnaire-Children(MIQ-C)
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Mental Chronometry for Timed Up and Go Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
Secondary outcomes:
measure: Gross Motor Function Classification System (GMFCS)
timeFrame: At Baseline
measure: Modified Tardieu Scale (MTS)
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Conner's Parent Rating Scale-Revised Short form (CPRS-RS)
timeFrame: At Baseline
measure: Mini-Mental State Exam For Children (Mmc)
timeFrame: At Baseline
measure: Surface electromyography (sEMG)
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Pediatric Evaluation of Disability Inventory (PEDI)
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Pediatric Outcomes Date Collection (PODCI) (Questionnaire)
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Timed Up and Go Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: 10-Meter Walk Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Five Times Sit to Stand Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Mental Chronometry for 10-Meter Walk Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Mental Chronometry for Five Times Sit to Stand Test
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Laterality Task
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Functional muscle strength
timeFrame: Change from Baseline at 8 weeks and 14 weeks
measure: Motor imagery entertainment scale
timeFrame: Change from Baseline at 4 weeks and 8 weeks
measure: Motor imagery clarity scale
timeFrame: Change from Baseline at 4 weeks and 8 weeks
Other outcomes:
Locations:
city: Bolu
country: Turkey
facility: Bolu Abant Izzet Baysal University
Study officials:
affiliation: Abant Izzet Baysal University
name: Eylem T Yümin
role: STUDY_DIRECTOR
References:
citation: Steenbergen B, Craje C, Nilsen DM, Gordon AM. Motor imagery training in hemiplegic cerebral palsy: a potentially useful therapeutic tool for rehabilitation. Dev Med Child Neurol. 2009 Sep;51(9):690-6. doi: 10.1111/j.1469-8749.2009.03371.x.
citation: Steenbergen B, Jongbloed-Pereboom M, Spruijt S, Gordon AM. Impaired motor planning and motor imagery in children with unilateral spastic cerebral palsy: challenges for the future of pediatric rehabilitation. Dev Med Child Neurol. 2013 Nov;55 Suppl 4:43-6. doi: 10.1111/dmcn.12306.
citation: Lust JM, Wilson PH, Steenbergen B. Motor imagery difficulties in children with Cerebral Palsy: A specific or general deficit? Res Dev Disabil. 2016 Oct;57:102-11. doi: 10.1016/j.ridd.2016.06.010. Epub 2016 Jul 9.