Effect of Task Oriented Training With Functional Electrical Stimulation on Balance in Children With Hemiparesis
To investigate the efficacy of combination of task-oriented training and Functional electrical stimulation of ankle dorsiflexor muscles on:
- Strength of ankle muscles in children with hemiparesis.
- Balance in children with hemiparesis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Nourhan Reda Abdel Razek Dawood, physical therapist
- Phone Number: 01017173755
- Email: Eman_pediatrics2016@yahoo.com
Study Locations
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Damietta, Egypt
- Recruiting
- Damietta general hospital.
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Contact:
- Nourhan Reda Abdel Razek Dawood, physical therapist
- Phone Number: 01017173755
- Email: Eman_pediatrics2016@yahoo.com
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The age of the selected children will be ranged from 6 to 9 years.
- Able to follow simple instructions.
- Degree of spasticity is ranging from 1to 1+ according to modified Ashworth scale.
- The level of motor function of the children will be levels I-II according to Gross Motor Function Classification System.
Exclusion Criteria:
The children will be excluded if they have one or more of the following criteria:
- Visual, hearing disorders.
- Recent Botox injection or orthopedic surgery in the lower limb in the last 6 months before the start of the study.
- Any fixed deformity of lower limb.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: conventional exercise program
The control group consist of 18 children will receive conventional exercise program for 60 min.
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The program will run three days a week on non-consecutive days, focusing on various exercises for children.
Activities include: 1) knee manipulation for balance; 2) guided body weight shifting; 3) balancing on a board; 4) training for equilibrium and protective reactions; 5) gait training in a closed environment with obstacles; 6) open environment gait training; 7) strengthening exercises for the back, hips, and knees; and 8) passive stretching for tight muscles in both lower and upper limbs.
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Experimental: task-oriented training
Study group consist of 18 children will receive task-oriented training while applying the functional electrical stimulation on the affected lower limb for 20 min in addition to conventional exercise program for 40 min.
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The program will run three days a week on non-consecutive days, focusing on various exercises for children.
Activities include: 1) knee manipulation for balance; 2) guided body weight shifting; 3) balancing on a board; 4) training for equilibrium and protective reactions; 5) gait training in a closed environment with obstacles; 6) open environment gait training; 7) strengthening exercises for the back, hips, and knees; and 8) passive stretching for tight muscles in both lower and upper limbs.
1. Activities involve standing and reaching for objects at various distances and heights.
2. Sit-to-stand tasks are performed from different chair heights and while carrying objects.
3. Stepping activities occur in various directions and on different block heights and surfaces.
4. Alternating heel and toe raises focus on increasing repetitions.
5. Stairs are ascended and descended with added weight and object carrying.
6. Backward walking starts near a wall, progressing to shuttle runs.
7. Walking on a balance beam involves increased speed and varied surfaces.
The study will utilize Everyway Medical Instruments for electrical stimulation, with one electrode on the tibialis anterior muscle and the other on the common peroneal nerve.
A tilt sensor will trigger stimulation during the swing phase of the tibia.
The stimulation parameters include a pulse frequency of 25-40 hertz, a pulse duration of 250 to 300 milliseconds, and an on-off time ratio of 1:2 for 20 minutes, aimed at inducing ankle dorsiflexion while preventing inversion.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Assessment of balance
Time Frame: at baseline and after 8 weeks
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Pediatric balance scale will be used to assess balance for all children participated in this study.
It contains 14-item.
Scoring for each item is scored 0 points (lowest function) to 4 points (highest function), with maximum score of 56 points.
Calculation of the total score by summation of the score of the 14 items
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at baseline and after 8 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Assessment of muscle strength
Time Frame: at baseline and after 8 weeks
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Each child will practice two trials per test to ensure familiarity.
Peak force values will be recorded using the handheld dynamometer after three trials for both break and method tests for each muscle group.
Standardized instructions will be provided, and encouragement will be given for maximal effort.
During the break test, force will increase progressively over one second to maximize muscle fiber activation.
Children will be shown test conduct prior to starting three trials.
For the tibialis anterior muscle test, children will lay on a plinth with legs restrained and push against a device with their foot.
Assessing ankle muscle groups, especially plantar flexors and dorsiflexors, is crucial for understanding power generation in walking and gait speed, particularly in stroke patients, while testing positions will be optimized for clinical feasibility.
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at baseline and after 8 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Nourhan_Msc
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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