None listed
Conditions
Brief summary
Individuals with spastic hemiplegic cerebral palsy (SH-CP) face a decrease in functional ability between 10 and 35 years of age, limiting health and quality of life. Interventions that reduce this decline are critical. Though loss of strength has been linked to functional decline in SH-CP, strength training (ST) programs have proven ineffective in improving neuromuscular function and are limited by relatively small strength gains. Strength gains may be slower in SH-CP as a result of alterations in the balance between excitation and inhibition in the primary motor cortex of the brain. The research proposed here will explore this issue using functional near-infrared spectroscopy (fNIRS) to measure brain activity during strength tasks, and to evaluate possible adaptions due to strength training. It will determine the impact of anodal transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, on the observed pattern of neural activity and subsequently, determine whether anodal tDCS, prior to ST, leads to faster and larger strength gains in CP. This research has the potential to improve ST outcomes in SH-CP and lead to increased understanding of the adaptions of the brain in response to anodal tDCS and exercise in SH-CP.
Interventions
Strength training + Transcranial Direct Current Stimulation.
Participants will perform a 12-week one-on-one strength training intervention with a focus on the upper limbs, under the supervision of an Accredited Exercise Physiologist, with the assistance of a PhD candidate. Participants will be trained at Victoria University Clinical Exercise and Rehabilitation (VUCER) clinic. This program will operate for three days per week; thirty minutes per day. The training program will consist of 1) 5 min
Strength training + Transcranial Direct Current Stimulation. Participants will perform a 12-week one-on-one strength training intervention with a focus on the upper limbs, under the supervision of an Accredited Exercise Physiologist, with the assistance of a PhD candidate. Participants will be trained at Victoria University Clinical Exercise and Rehabilitation (VUCER) clinic. This program will operate for three days per week; thirty minutes per day. The training program will consist of 1) 5 min aerobic exercise with an arm cycle ergometer; 2) 20 min strength exercise at 70% of 1RM of the upper part of the body; and 3) 5 min of stretching. Before each strength training session, 2 mA anodal tDCS over the primary motor cortex will be applied for 20 minutes. Anodal tDCS is a type of brain stimulation that involves placing electrodes over the head, which delivers low direct current through to the underlying brain. Anodal stimulation is positive, which means that the current will stimulate the part of the brain where the electrode is placed. This study will be utilizing progressive resistance strength training, commonly used in people with CP. Participants will be asked to complete 2-3 sets of 12 repetitions maximum of each exercise (which correspond to an intensity of around 70% of 1RM), with at least 1 min between set. The weight will be increased by 5% at the successful completion of 2-3 set of 12 repetitions.
Sponsors
Victoria University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
Diagnosis of spastic hemiplegic cerebral palsy. Intellectual capacity to understand and cooperate during the proposed activities.
Exclusion criteria
Surgical procedures or neurolytic block in the 12 months prior to testing; Orthopedic deformity of the upper limb with an indication for surgery; Epilepsy; Pregnancy; Contraindication for tDCS as per screening questionnaire, and / or any acute medical disorder that would make strength training contraindicated, including active malignancy, severe heart, lung, renal, and liver failure.
Outcome results
None listed