Cerebral palsy Nervous System Diseases Cerebral palsy
Conditions
Interventions
Target Population: Ambulant children with spastic hemiplegic or diplegic cerebral palsy (Gross Motor Classification I-III) will be recruited through two routes:
1. Participants will be recruited via
Sponsors
Plymouth University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. 6 to 16 years old 2. Diagnosis of cerebral palsy 3. Gross Motor Classification Scale (GMFCS I to III) 4. Able to stand up and walk without adult assistance 5. Increased muscle tone
Exclusion criteria
Exclusion criteria: 1. Surgery or Botulinum Toxin Injections in the last 3 months 2. Medical advice to limit weight bearing or leg movement 3. Popliteal angle > 80o
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Measures taken within 1 session, T=0 baseline, T1= post intervention: Phase 1: Stretch reflex size: surface electromyography will measure medial hamstrings and rectus femoris activity. Stretch reflex amplitude will be determined as the mean between the onset and offset of the muscle activation (defined as the point when the rectified EMG signal falls above/below a target indicated by the mean pre-stretch baseline period + 2 standard deviations for at least 10 ms) Phase 2: Hamstring extensibility, measured with a goniometer: the test leg will be moved to 90° hip flexion and then popliteal angle will be measured | — |
Secondary
| Measure | Time frame |
|---|---|
| Measures taken within 1 session, T=0 baseline, T1= post intervention: Phase 1: 1. Stretch reflex latency, measured using the same EMG data as for the primary outcome, the analysis for the stretch reflex onset will be determined by the time the EMG rises above/below a level (baseline mean + 2 standard deviations) for at least 10 ms 2. Passive stiffness, measured using the data from the customised motor, this measures the torque (by an in series torque transducer) and motor position. Passive stiffness will be determined as the change in torque/change in position over a 300 ms window immediately before and after the stretch, so the change in resistance from before and during the passive movement will show the passive stiffness Phase 2: 1. Clinical measure of stiffness (modified Wartenburg's test). The participant will be lying on their front with the lower leg over the edge of the bed. The leg will be raised and allowed to drop with gravity. The researchers will record how quickly the leg drops using sensors that are placed above and below the knee and attached using Velcro straps. They will record three drops and the test should take 3 minutes 2. Time to sit to stand: how quickly the child can stand up from sitting 5 times. The use of arms and any aids to help push up are allowed if needed. There will be a two-minute maximum time allowance. 3. Knee velocity while walking: the speed of knee movement as the child walks 5 m and the time they take to walk over the distance. The child should use any walking aids typically used. 4. Quality during walking, measured using the Quality FM during the 5-meter walkthrough video analysis | — |
Countries
England, United Kingdom
Outcome results
None listed