Neuromotor Control During Walking in Children With Cerebral Palsy

University of Delaware34 enrolled

Overview

One out of every three children with cerebral palsy (CP) falls daily, with more than half of the falls occurring while walking. To avoid falling, the nervous system must continuously monitor how the body moves and, when an imbalance is detected, activate muscles for an appropriate correction. In this project, we will use small electrical stimulation of muscles and tendons that enhances the sense of body positioning, to allow children with CP to generate more accurate balance corrections.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

SINGLE

Enrollment

Conditions

Cerebral Palsy

Interventions

Stochastic Resonance (SR)DEVICE

The system consists of six linear isolated stimulators (STMISOLA, Biopac Systems, Inc., Goleta, USA). The SR signal (Gaussian White Noise, zero mean) will be generated through a 16 bit PCI 6733 National Instruments multifunction data acquisition card by a custom LabView program. The stimulation sites include the ankle, lateral soleus, peroneus longus, and tibialis anterior muscles and the hip.

Eligibility

Sex: ALLMin age: 8 YearsMax age: 8 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age 8 - 24 years * Diagnosis of spastic diplegic or hemiplegic CP (for participants with CP group only) * GMFCS classification level I or II (ability to walk independently with using any assistive device) * Visual, perceptual, and cognitive/ communication skills to follow multiple step commands * Seizure-free or well controlled seizures * Ability to communicate pain or discomfort during testing procedures * Parental/guardian consent and child assent/consent Exclusion Criteria: * Diagnosis of athetoid, ataxic or quadriplegic CP * Significant scoliosis (scoliometer angle \> 9°) * History of selective dorsal root rhizotomy * Botox injections in the lower limb within the past 6 months * Severe spasticity of the lower extremity muscles (e.g. a score of 4 on the Modified Ashworth Scale) * Severely limited range of motion/ irreversible muscle contractures * Lower extremity surgery or fractures in the year prior testing * Joint instability or dislocation in the lower extremities * Marked visual or hearing deficits

Locations (1)

University of Delaware

Newark, Delaware, United States

Outcomes

Primary Outcomes

Change in Margin of Stability(MOS)

MOS refers to the distance between extrapolated center of mass (which includes center of mass position and velocity) and the base of support. It has been previously used to measure balance in children with cerebral palsy, patients with stroke, Parkinson Disease, and Multiple Sclerosis. We will measure center of mass using kinetics and kinematic computed through a motion capture system(Qualysis). For the visual perturbation conditions, we will use center of mass excursion as the primary outcome measure (since it has been used in prior studies in children and adults using visual perturbation protocols).

Time frame: At the end of the session after 6 minutes of stimulation i.e Pre stimulation MOS - Post stimulation MOS.

Data from ClinicalTrials.gov

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