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Quadriceps Muscle Plasticity in Children With Cerebral Palsy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00629070
Recruitment Status : Completed
First Posted : March 5, 2008
Last Update Posted : May 17, 2018
Information provided by (Responsible Party):
Medical University of South Carolina

Brief Summary:
Our primary aim is to determine whether and how muscle architecture of the quadriceps muscles in cerebral palsy (CP) adapts to two separate training programs: traditional strength training (ST) vs. velocity-enhanced training (VT). For the ST group, we hypothesize that muscle size will increase in conjunction with strength. For the VT group, in addition to the above, we hypothesize that fiber length will increase with measures of muscle power. We also hypothesize that walking velocity will improve in both groups but that knee motion and step length will improve only with VT.

Condition or disease Intervention/treatment Phase
Cerebral Palsy Other: Traditional strength training Other: Velocity-enhanced training Not Applicable

Detailed Description:
Cerebral palsy (CP) is the most common physical disability originating in childhood, occurring in 2-3 per 1,000 live births. Although the primary deficit in CP is injury to the brain, secondary impairments affecting muscle function such as weakness, contractures, and spasticity are often far more debilitating and lead to worsening disability throughout the lifespan. Some have suggested that these muscle changes in CP may be irreversible; however, it is now known that muscles are one of the most 'plastic' tissues in the body. In fact, recent evidence suggests that gross muscle hypertrophy and architectural changes within muscle fibers can occur as early as 3-5 weeks after resistance training in healthy adults. It is also unknown how effectively muscles in CP can adapt to training stimuli that target specific muscle architectural parameters, such as fascicle length and cross-sectional area. These parameters have been observed to be decreased in CP, suggesting loss of sarcomeres in-series (fiber shortening) and in-parallel (muscle atrophy). We propose here that specific training-induced muscle architectural adaptations can occur in CP, leading to improved motor function.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 16 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: In Vivo Assessment of Quadriceps Muscle Plasticity in Children With Cerebral Palsy
Actual Study Start Date : January 2009
Actual Primary Completion Date : December 13, 2010
Actual Study Completion Date : December 13, 2010

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: ST
Traditional strength training
Other: Traditional strength training
Performed 3 x week for 8 weeks on an isokinetic dynamometer (knee extension exercise)at 30 degrees/second; 6 sets of 5 maximum-effort concentric actions

Experimental: VT
Velocity-enhanced training
Other: Velocity-enhanced training
Performed 3 x week for 8 weeks on an isokinetic dynamometer (knee extension exercise). Subjects will perform 2 sets of 5 concentric exertions at 30°/second. The following 4 sets of 5 repetitions will be performed at a faster speed, starting at 60° /second. The velocity will be increased weekly in 15° /second increments up to a maximum of 120°/second.

Primary Outcome Measures :
  1. Muscle thickness [ Time Frame: before and after intervention ]

Secondary Outcome Measures :
  1. Fascicle length [ Time Frame: before and after intervention ]
  2. Muscle strength (peak torque) [ Time Frame: before and after intervention ]
  3. Muscle power [ Time Frame: before and after intervention ]

Information from the National Library of Medicine

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Ages Eligible for Study:   7 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosis of cerebral palsy
  • Gross motor function classification system levels I, II, or III
  • Ages 7 to 17

Exclusion Criteria:

  • Orthopedic or neurosurgery within the past year
  • Botulinum toxin injections within the 4 months prior to the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00629070

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United States, South Carolina
Neuromuscular Assessment Laboratory
Charleston, South Carolina, United States, 29414
Sponsors and Collaborators
Medical University of South Carolina
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Principal Investigator: Noelle G Moreau, PhD, PT Medical University of South Carolina
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Responsible Party: Medical University of South Carolina Identifier: NCT00629070    
Other Study ID Numbers: PDS 087657
First Posted: March 5, 2008    Key Record Dates
Last Update Posted: May 17, 2018
Last Verified: May 2018
Keywords provided by Medical University of South Carolina:
cerebral palsy
muscle strength
muscle architecture
rectus femoris
quadriceps muscle
Additional relevant MeSH terms:
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Cerebral Palsy
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Brain Damage, Chronic
Brain Diseases
Central Nervous System Diseases