Effects OF NMES With and Without Dynamic Bracing on Spasticity and Movement Quality in CP

Riphah International University42 enrolled

Overview

The study aims at comparing Neuromuscular electrical Stimulation with and without dynamic bracing on spasticity and movement quality of lower limb in Children with Cerebral Palsy

Cerebral palsy (CP) is a lifelong motor impairment caused by an early brain injury and affects 2-3 per 1,000 live births. It is a complex medical condition that negatively impacts cognition, language, sensations, movement, and gait patterns. It is normally carried out using a comprehensive approach that incorporates numerous approaches targeted at minimizing symptoms and improving functional outcomes. NMES (Neuromuscular and Muscular Electrical Stimulation) is an instrument that provides electrical impulses to nerves, causing muscles to contract, while dynamic bracing use muscle power to pre-compress soft tissue to produce the high forces required to control specific pathological diseases. The hip adductors, the knee flexor muscles, and the ankle and foot muscles (gastrocnemius and soleus may experience increased tone, causing the ankles to be held in a plantar-flexed (pointed downward) position) are targeted with NMES in the lower extremity to reduce the spasticity \& improve the quality of movement in CP children. Investigating how combining NMES with dynamic bracing benefits lumbar disc bulge patients adds to the growing body of evidence supporting multimodal treatment.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Diplegic Spastic Cerebral Palsy

Interventions

NMES with Dynamic BracingOTHER

The group will receive NMES along with dynamic bracing

NMES without Dynamic BracingOTHER

The participants will receive NMES on the lower extremity

Dynamic Bracing OnlyOTHER

This group will receive dynamic bracing only on the lower limb.

Eligibility

Sex: ALLMin age: 5 YearsMax age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 5 to 12 years. * Able to walk with or without an assistive device. Classification as level I-II on the Gross Motor Functional Classification System (GMFCS). * Able to stand with or without support for 1 minute. * Classification as levels I-III on the Manual Ability Classification System (MACS); and the ability to follow and accept verbal instructions. * Muscle tone scored ≥2, according to Modified Ashworth Scale. Exclusion Criteria: * Orthopedic Surgical intervention (e.g. tendon lengthening in lower limb) within the previous 12 months * Treatment with botulinum toxin in the calf muscles within the previous 6 months * Presence of structural deformities at the lower limbs and trunk, or instability in the ankle joint, which could compromise the child's safety and performance of the motor task * Severe affective or psychiatric impairments; * Serious vision or hearing problems * Any neurological impairment (epilepsy or any other disease that would interfere with physical activity)

Locations (1)

Children Hospital

Faisalābad, Punjab Province, Pakistan

Outcomes

Primary Outcomes

Modified Ashworth Scale

The scale is used to measure spasticity minimum score is 0 and maximum score is 4

Time frame: baseline and 6 weeks

Observable Movement Quality Scale

it is used assess the movement quality in children Minimum Score: 0 (indicating the poorest movement quality) and maximum is 24

Time frame: baseline and 6 weeks

Physicians Rating Scale

it is used to objectively documenting the hip, knee, ankle and foot changes in children with CP. Minimum Score: 0 (indicating no impairment or lowest severity) and Maximum score is 7

Time frame: baseline and 6 weeks

Data from ClinicalTrials.gov

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