Medulloblastoma is a rapidly-growing tumor of the cerebellum, this area controls balance, posture and sophisticated motor functions like finer hand movements, speech, and swallowing. It has been reported that those children fall frequently so the purpose of this study is to investigate the effectiveness of balance and coordination training in these Children.
The effects of physical exercise training interventions for childhood cancer participants are not yet convincing due to small numbers of participants and insufficient study methodology. More and high-quality evidence is needed in order to be able to draft exercise and physical activity guidelines for this population. Despite the positive results of exercise interventions in adult cancer patients, the evidence for benefits in childhood cancer patients is limited. There are Two Main objectives: 1. To investigate the effectiveness of Pilates core stability exercises program. 2. To investigate the effectiveness of Humac balance and tilt system. Secondary Objectives: 1. The effectiveness of coordination training in children with posterior fossa tumors. 2. The comparison between balance and coordination training and which of both trainings has more effect. This study will take place in a pediatric oncology setting, Children's Cancer Hospital Egypt(CCHE), in outpatient setting. Patients will be evaluated for their balance and coordination at initial presentation, during treatment, and during follow-up after end of treatment at CCHE. Also patients will receive balance and coordination training, before each chemotherapy cycle-maximum one week- given the patient is in good state. Sixty children with posterior fossa tumors of both sexes will participate in this study. They will be selected from CCHE. They will be randomly assigned into 3 groups of equal number.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Twenty patients will receive Pilates core stability exercises program ONLY. Total Period: 12 Weeks Stages: Three stages: * Stage I: Warm-up: consists of four Pilates motions: 1. Breathing: 2. Rolling back: 3. Coccyx-curl: 4. Hundred breathing: * Stage II: Work-out: consists of twelve Pilates motions: 1. Single leg stretch: 2. Straight leg raise: 3. Basic bridge: 4. Bridging variation: 5. Quadruped: 6. Clap with seal motion 7. Mermaid twist: 8. Swimming: 9. Double leg stretch: 10. Shoulder bridge: 11. Swan dive: 12. Leg full front: * Stage III: Cool-down: consists of three Pilates motions: 1. Rest position: 2. Cat with arm/leg extension: 3. Breathing:
Total Period: 12 Weeks. The designed HUMAC program will work on the modified clinical test of sensory integration of balance (mCTSIB) with eyes open and with eyes closed, the center of pressure (COP) and the limit of stability test (LOS).
Children's Cancer Hospital Egypt 57357
Cairo, Egypt
Change Balance
For assessment of the three groups, HUMAC balance and tilt system will be used to assess both Static and dynamic balance.
Time frame: at week 12
Change Coordination
The Bruininks-Oseretsky Test of Motor Proficiency - Second Edition \- The minimum and maximum values: Coordination will be assessed using BOT2, Bilateral coordination (Sub test No.4) composed of 7 items and Upper-Limb coordination (Sub test No.7) composed of 7 items too. The raw scores are recorded first then it is converted into point scores, then subtest total point score is obtained by adding point scores. Bilateral Coordination: Total Point Score Subtest (min=Zero, max=24). Upper-Limb Coordination: Total Point Score Subtest (min=Zero, max=39). \- Higher scores mean a better outcome.
Time frame: at week 12
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Total Period: 12 Weeks. Coordination will be assessed using BOT2, Bilateral coordination (Sub test No.4) composed of 7 items and Upper-Limb coordination (Sub test No.7) composed of 7 items too. The raw scores are recorded first then it is converted into point scores, then subtest total point score is obtained by adding point scores.