Effects of Physical Training Following Selective Dorsal Rhizotomy on Non-ambulant Children With Bilateral Spastic Cerebral Palsy

Effects of Physical Training Following Selective Dorsal Rhizotomy on Trunk Control, Selectivity and Upper Extremity Function of Non-ambulant Children With Bilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

Children with spastic bilateral cerebral palsy are late developers. delayed gross and fine motor development require early intervention to improve the child performance and avoid secondary impairments.

Study Overview

• Status: Completed
• Conditions: Bilateral Cerebral Palsy
• Intervention / Treatment: Other: physical therapy excercises; Other: Standard Orthotic Management; Other: selective dorsal rhizotomy

Detailed Description

increased tone of lower extremity muscles interfere with the child sitting posture and trunk control. delayed sitting and lack of trunk control contribute to the impairments of upper extremity functions.

selective dorsal rhizotomy is a surgical procedure to control increased tone of the lower extremities. Therefore, the current study is carried out to investigate the effects of selective dorsal rhizotomy on trunk control, selectivity and upper extremity function of non-ambulant children with bilateral spastic cerebral palsy

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt, 12662
    • Amira Mahmoud Abd-elmonem

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 years to 7 years (Child)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• CP, spastic diplegia
• 4-7 years of age
• On Level IV-V on Gross Motor Function Classification System
• Partial trunk control (sitting with support).

Exclusion Criteria:

• Structural non-reducible deformities or musculoskeletal surgery in the lower extremities in the past 12 months
• Ankle clonus
• Exaggerated deep tendon reflex in the legs
• Babinski sign;
• Moderate to severe signs of dystonia, athetosis or ataxia.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: control group	Other: physical therapy excercises; Sequenced trunk co-activation exercises; Righting and protective reactions; Functional stretching exercises.; Other: Standard Orthotic Management; A custom-made articulating ankle foot orthosis
Experimental: SDR-group; selective dorsal rhizotomy	Other: physical therapy excercises; Sequenced trunk co-activation exercises; Righting and protective reactions; Functional stretching exercises.; Other: Standard Orthotic Management; A custom-made articulating ankle foot orthosis; Other: selective dorsal rhizotomy; All SDRs were performed by a single neurosurgeon through an osteoplastic laminotomy from L2 to L5

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Segmental trunk control	The Segmental Assessment of Trunk Control is applied to assess upright trunk postural control in sitting position based on subdividing the trunk into 6 segments. The head/trunk control is acquired segment by segment if upright sitting posture can be maintained under three conditions including: static control at static position, active control while the child moves the head and/or arm and reactive control after external perturbation.The trunk segments according to the scale include: head/neck, thoracic (upper, mid and lower) and lumbar (upper and lower) segments. It is an ordinal scale with a grade 1 to 7 is assigned for each segment with the score 7 indicates that the infant can't retain independent sitting (no hand support). A score of 8 is given as full trunk control is gained.	period of the treatment was 4 successive months
Gross motor function	The gross motor function measure-88 is a valid and reliable criterion referenced instrument; is currently used to evaluate the motor function over time in individuals with cerebral palsy.	period of the treatment was 4 successive months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
upper extremity function	The quality of upper extremity skill test is a reliable and valid tool used to measure the motor function in children with cerebral palsy ages of 18 months to 8 years. T	period of the treatment was 4 successive months

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Hazem A Aly, Phd, PhD of physical therapy for pediatrics, faculty of physical therapyCairo university; Study Director: Ahmed rabie, Phd, Department of neurosurgery, faculty of medicine , Alexandria university

Study record dates

Study Major Dates

• Study Start (Actual): August 10, 2022
• Primary Completion (Actual): January 30, 2024
• Study Completion (Actual): December 24, 2025

Study Registration Dates

• First Submitted: August 7, 2021
• First Submitted That Met QC Criteria: August 7, 2021
• First Posted (Actual): August 16, 2021

Study Record Updates

• Last Update Posted (Actual): April 28, 2026
• Last Update Submitted That Met QC Criteria: April 23, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Motor development; Bilateral Cerebral Palsy; Selective dorsal rhizotomy; segmental trunk control
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Brain Damage, Chronic; Cerebral Palsy; Paralysis
• Other Study ID Numbers: spastic cerebral palsy

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No