Cerebral palsy. Static balance. Physical therapy.
Conditions
Interventions
All participants will be submitted to the administration of BT-A in the lower limbs, performed by a single specialist in physical rehabilitation. The injected muscles will be determined based on the a
Drug
Other
H02.010.625
E02.779.483.750
A01.378.610.250.149
Sponsors
Universidade Node de Julho
Universidade Node de Julho
Eligibility
Age
5 Years to 12 Years
Inclusion criteria
Inclusion criteria: Age between five and 12 years. Spastic, diplegic cerebral palsy. Motor function classified as Level I, II or III by the GMCFS. Independent ambulation with or without the need for a gait-assistance device (walker or crutches). Dynamic equinus with indication for neuromuscular block with BT-A in the triceps surae. Availability for physical therapy twice a week for four months. The following inclusion criteria will also apply to one group of children: 1) degree of cooperation compatible with the administration of NMES and 2) tolerance to NMES at a motor threshold level (visible muscle contraction).
Exclusion criteria
Exclusion criteria: Neurological or orthopedic conditions unrelated to cerebral palsy. Orthopedic surgery on the lower limbs in the 12 months prior to selection. Surgery scheduled during the period of the study. Equinus not reducible to neutral (ankle at 0 degrees) or incompatible with the use of orthoses following the application of BT-A in the triceps surae.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Investigate the effect of NMES on dorsiflexor muscles in combination with motor physical therapy on static balance (oscillations from the center of pressure in the anteroposterior and mediolateral directions) in children with CP submitted to BT-A in the lower limbs in order to diminish spasticity. Static balance will be evaluated using a pressure platform (Medicapteurs Fusyo) This device measures oscillations in the center of pressure (COP) and contact time between the feet and the surface of the platform. The acquisition frequency will be 40 Hz. The children will be placed in an orthostatic position, barefoot, with arms alongside the body and eyes focused on a point marked at a distance of one meter positioned at the height of the glabella of each child. The evaluation will be carried out under two conditions for 30 seconds each: eyes open and eyes closed. The data will be recorded and interpreted using the Fusyo Analysis software program. | — |
Secondary
| Measure | Time frame |
|---|---|
| Investigate the effect of NMES in the ankle dorsiflexor muscles in combination with motor physical therapy on functional balance, as assessed by the Berg Balance Scale, in children with CP submitted to BT-A in the lower limbs. The Berg Balance Scale will be used for the assessment of functional balance. This is a simple 14-item measure that addresses the performance of functional balance common to daily living. Each item has a five-option ordinal scale ranging from 0 to 4 points, with a maximal overall score of 56. The points are based on the time in which a position is maintained, the distance an upper limb is able to reach in front of the body and the time needed to complete the task. Execution time is approximately 30 minutes. The children will perform these tasks dressed, but barefoot. | — |
Countries
Brazil
Contacts
Public ContactClaudia Oliveira
Universidade Nove de Julho
Outcome results
None listed