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Targeted Hip Strength Training in Children With Cerebral Palsy (CP)

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: NCT01633736
Recruitment Status : Unknown
Verified July 2012 by University of Nottingham.
Recruitment status was:  Recruiting
First Posted : July 4, 2012
Last Update Posted : July 4, 2012
Information provided by (Responsible Party):
University of Nottingham

Brief Summary:
This study's main aim is to look at targeted strength training for muscles at the hips. Specifically to consider whether targeted strength training not only effects strength of the specific muscles but also ability to stand on one leg (single leg balance) as well as walking in children with cerebral palsy? This study is a feasibility of method of investigation.

Condition or disease Intervention/treatment Phase
Cerebral Palsy Other: Usual care plus progresive resistance training Phase 3

Detailed Description:
This study is focusing on functional change. The reasoning is that if the targeted strength training is effective at improving hip muscle contribution to stability then single leg balance may be improved. This may be functionally evident when weight bearing is taken by say the left leg in gait (percentage stance phase of gait) and as a consequence the opposing swing phase will be optimised as measured by stride. Thus the research question is does strengthening of the rotating and sideways moving hip muscles improve the walking of children with CP as measured by appropriate aspects of gait? Secondly, does this targeted strengthening also increase duration of single leg balance which is a simple easy to use measure in the community without the need for specialised equipment? The primary outcome measure will use a laboratory based 4 camera Codsmotion (CODA) biomechanical analysis system to measure stride (a) and percentage duration of stance phase of gait (b). Secondarily the duration of single leg balance in terms of seconds will be recorded. Gross motor functional and quality of life as also being assessed. The intervention is strengthening which will be implemented with the principles of progressive resistance training. Children with CP's therapists would ask for this type of intervention to be carried out

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Targeted Hip Progressive Resistance Training to Improve Single Leg Balance and Walking in Children With Cerebral Palsy
Study Start Date : December 2011
Estimated Primary Completion Date : March 2013
Estimated Study Completion Date : March 2013

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: home progressive resistance exercise Other: Usual care plus progresive resistance training
Duration 8 weeks; two weeks of familiarisation with the intervention protocol without resistance (for familiarisation and neural adaptation) followed by 6 weeks progressive resistance (PR). The three times a week PR training will be as a home exercise program with fortnightly home visits to monitor/progress PR training. It comprises a 4 minute warm up and cool down with one exercise targeting the hip abductors and one the lateral rotators. Exercise prescription will follow existing guidelines for progressive PR training. Parents will be taught supervision by the researcher using clear explanations in words and pictures in a logbook. Logbooks have been found to facilitate compliance, dosage and motivation.
Other Name: strength training

Primary Outcome Measures :
  1. Gait parameter [ Time Frame: baseline, plus 8 weeks and plus 8 weeks (exit point) ]
    4 camera CODA gait analysis system for change in percentage stance phase of gait and stride in cm.

Secondary Outcome Measures :
  1. Gross Motor Function Measure (GMFM) [ Time Frame: Baseline, plus 8 weeks and plus 8 weeks (exit) ]
    To investigate any change in dimensions D and E of fucntioal activity with standardised GMFM.

Information from the National Library of Medicine

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Ages Eligible for Study:   7 Years to 16 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Children with CP aged between 7-16 years having sufficient cognition to undertake a strength training program

Exclusion Criteria:

  1. non-ambulation children or those unable to walk 5 meters independently (without walking aid),
  2. lower limb surgery within 12 months,
  3. botox within 6 months,
  4. oral muscle relaxant medication
  5. significant learning difficulty
  6. Any concurrent condition which would be contraindicated to progressive resistance training such as unmanaged high blood pressure, cardiac pathology or uncontrolled epilepsy
  7. Where at baseline assessment finds no weakness in the muscles under investigation
  8. concurrent or within 6 months involvement in any other research study
  9. Non consent to General Practitioner (GP) notification.

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): NCT01633736

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Contact: Sarah E Westwater-Wood, MMedSci, BSc +44 115 8231793
Contact: Grahame Pope, MPhil, BSc +44 115 8231785

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United Kingdom
Divison of Physiotherapy, School of Nursing, Midwifery and Physiotherapy, The University of Nottingham Recruiting
Nottingham, Nottinghamshire, United Kingdom, NG5 1PB
Contact: Grahame Pope   
Principal Investigator: Sarah E Westwater-Wood         
Sponsors and Collaborators
University of Nottingham
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Principal Investigator: Grahame Pope, MPhil, BSc The University of Nottingham
Cans, C., et al., Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy. , in The Definition and Classification of Cerebral Palsy, P. Baxter, Editor. 2003, the SCPE collaborative group.
Pallant, J (2001) SPSS Survival Manual. Edition 10, Open University Press, Buckingham.Philadelphia
Levitt, S., Treatment of Cerebral Palsy and Motor Delay. 3rd Edition ed. 1995: Blackwell Science.
Tran, Q.T., Cerebral palsy; considerations for training. Strength and Conditioning Journal, 2005. 27(6): p. 34-38
Johnson, L.M., et al., The effect of plantarflexor muscle strengthening on the gait and range of motion at the ankle in ambulant children with cerebral palsy: a pilot study. New Zealand Journal of Physiotherapy, 1998. April: p. 8-14.
Perry, J., Gait Analysis Normal and Pathological Function. 1992, Thorofare, NJ: SLACK Inc. 502.
Gage, J., The treatment on gait problems in cerebral palsy. 2004: MAcKeith Press.
Palastanga, N., D. Field, and R. Soames, Anatomy and Human Movement structure and function Vol. 5th. 2006: Elsevier.
Darrah, J., et al., Review of the effects of progressive resisted muscle strengthening in children with cerebral palsy: a clinical consensus exercise. Pediatric Physical Therapy, 1997. 9: p. 12-17.
Armstrong, N. and W. van Mechelen, Paediatric exercise science and medicine. 2nd ed. 2008: Oxford University Press
Brooks, G., Fahey. TD., and K. Baldwin, Exercise physiology; human bioenergetics and its applications. 4th ed. 2004: McGraw Hill.
Coe R (2002) It's the Effect Size, Stupid; What effect size is and why it is important Paper presented at the Annual Conference of the British Educational Research Association, University of Exeter, England, 12-14 September 2002

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Responsible Party: University of Nottingham Identifier: NCT01633736    
Other Study ID Numbers: UoN-SWW-2
First Posted: July 4, 2012    Key Record Dates
Last Update Posted: July 4, 2012
Last Verified: July 2012
Keywords provided by University of Nottingham:
single blinded
cerebral palsy
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