Bilateral Cerebral Palsy
Conditions
Keywords
Bilateral Cerebral Palsy, Selective dorsal rhizotomy, segmental trunk control, Motor development
Brief summary
Children with spastic bilateral cerebral palsy are late developers. delayed gross and fine motor development require early intervention to improve the child performance and avoid secondary impairments.
Detailed description
increased tone of lower extremity muscles interfere with the child sitting posture and trunk control. delayed sitting and lack of trunk control contribute to the impairments of upper extremity functions. selective dorsal rhizotomy is a surgical procedure to control increased tone of the lower extremities. Therefore, the current study is carried out to investigate the effects of selective dorsal rhizotomy on trunk control, selectivity and upper extremity function of non-ambulant children with bilateral spastic cerebral palsy
Interventions
OTHERphysical therapy excercises
* Sequenced trunk co-activation exercises * Righting and protective reactions * Functional stretching exercises.
A custom-made articulating ankle foot orthosis
All SDRs were performed by a single neurosurgeon through an osteoplastic laminotomy from L2 to L5
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Random allocation of participants will be completed using a random number generator, with the allocation to either the control or selective dorsal rhizotomy group being concealed. The random numbers are generated by the principle physical therapists with every alternate number being marked either "1" or "2." However, the receptionist was blinded to the interventions assigned to group 1 (control group) and group 2 (SDR group). During allocation, every parent/legal guardian is asked to pick up one enclosed envelope from a box containing numbers from 1 to 30. Then, they are allocated to either group 1 or group 2 to minimize the risk of allocation bias.
Eligibility
Sex/Gender
ALL
Age
4 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
* CP, spastic diplegia * 4-7 years of age * On Level IV-V on Gross Motor Function Classification System * Partial trunk control (sitting with support).
Exclusion criteria
* Structural non-reducible deformities or musculoskeletal surgery in the lower extremities in the past 12 months * Ankle clonus * Exaggerated deep tendon reflex in the legs * Babinski sign; * Moderate to severe signs of dystonia, athetosis or ataxia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Segmental trunk control | period of the treatment was 4 successive months | The Segmental Assessment of Trunk Control is applied to assess upright trunk postural control in sitting position based on subdividing the trunk into 6 segments. The head/trunk control is acquired segment by segment if upright sitting posture can be maintained under three conditions including: static control at static position, active control while the child moves the head and/or arm and reactive control after external perturbation.The trunk segments according to the scale include: head/neck, thoracic (upper, mid and lower) and lumbar (upper and lower) segments. It is an ordinal scale with a grade 1 to 7 is assigned for each segment with the score 7 indicates that the infant can't retain independent sitting (no hand support). A score of 8 is given as full trunk control is gained. |
| Gross motor function | period of the treatment was 4 successive months | The gross motor function measure-88 is a valid and reliable criterion referenced instrument; is currently used to evaluate the motor function over time in individuals with cerebral palsy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| upper extremity function | period of the treatment was 4 successive months | The quality of upper extremity skill test is a reliable and valid tool used to measure the motor function in children with cerebral palsy ages of 18 months to 8 years. T |
Countries
Egypt
Contacts
STUDY_CHAIRHazem A Aly, Phd
PhD of physical therapy for pediatrics, faculty of physical therapyCairo university
STUDY_DIRECTORAhmed rabie, Phd
Department of neurosurgery, faculty of medicine , Alexandria university
Outcome results
None listed