Effects of Different Focuses of Attention on Walking and Balance in Children With Cerebral Palsy

December 30, 2024 updated by: Rabia ZORLULAR, Gazi University

Investigation of the Effects of Different Focuses of Attention on Functional Walking and Balance in Children With Cerebral Palsy

This study was planned to examine the effects of different focuses (external and internal focus)of attention on functional walking and balance in children with cerebral palsy. Individuals with CP between the ages of 6-18 will be included in the research. It was planned to include 24 individuals in total, 12 individuals in each group.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In the external focus of attention (EF), attention is directed to movement and an environmental stimulus. In the internal focus (IF), attention is directed directly to body movements. In revealing positive effects in external focus; Methods such as metaphor, analogy, imaginary objects, mental analogies can be used. Adopting an External focus of attention (focusing on the effects of movements on the object or environment), as opposed to an Internal focus of attention (focusing on body movements), has been found to significantly improve performance on a variety of tasks. Walking and balance are essential for activities of daily living and social participation; Therefore, it is often considered one of the most important activities in daily life. Walking and balance is an automatic rhythmic motor behavior controlled mostly by subcortical brain regions. Automaticity means that walking can be performed without requiring attention. Although it seems like a very simple activity, it is actually a very complex chain of movements in which the brain, spinal cord, muscles, bones and joints work together in coordination. However, movement, balance and gait disorders cause individuals with CP to spend more energy, deteriorate their mobility and decrease their independence. Although the beneficial effects of EF have not yet been demonstrated for every population, the constrained action hypothesis encourages the use of an EF for teaching motor skills. Looking at the literature, the effects of EF on the development of motor performance in children with cerebral palsy have not been examined. Therefore, this study aims to examine the effects of external focus of attention on gait and balance.

Individuals with CP between the ages of 6-18 will be included in the research. After the purpose and scope of the study are explained to all individuals and their families who agree to participate in the study, their families will be asked to read and sign the volunteering form. All individuals who meet the inclusion criteria will be randomly divided into 2 groups (external focus and internal focus). It was planned to include 24 individuals in total, 12 individuals in each group. The same evaluations will be made to all individuals participating in the study by a physiotherapist who is an expert in the field. In addition to conventional physiotherapy for 6 weeks, individuals will be included in an exercise program that focuses on external and internal attention for 30 minutes a day, 3 days a week. Evaluation of walking function will be done with the C-Mill Walking Training System. Balance function will be performed by standing on one leg, pediatric berg balance scale and functional reaching tests.Independence Pediatric Functional Independence Scale will be evaluated with.Trunk control, trunk control measurement scale will be evaluated with.

Study Type

Observational

Enrollment (Actual)

24

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Ankara, Turkey
        • Rabia ERASLAN

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Children with hemiparatic cerebral palsy between the ages of 6 and 18 will be included in the study.

In order to perceive the commands during the exercise, the children participating in the study must have a level of cognitive development to be cooperative.

Description

Inclusion Criteria:

  • Being diagnosed with spastic type cerebral palsy between the ages of 6-18
  • Volunteerism of the family and individuals to participate in the study
  • Being at levels I and II according to the Gross Motor Classification System
  • Having the cognitive development to be cooperative

Exclusion Criteria:

  • Having undergone any orthopedic and/or neurological surgery in the last 6 months,
  • Having hearing and/or vision loss that would prevent participation in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
external odak
Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs and tracks will be built to improve walking and balance functions. During exercises, attention is directed to movement and an environmental stimulus in the external focus of attention.
Other: Exercise
Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs and tracks will be built to improve walking and balance functions. One group will be given external focus stimuli, the other group will be given internal focus stimuli.
internal focus
Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs, and tracks will be built to improve walking and balance functions. In internal focus during exercises, attention is directed directly to body movements.
Other: Exercise
Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs and tracks will be built to improve walking and balance functions. One group will be given external focus stimuli, the other group will be given internal focus stimuli.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gait
Time Frame: 6 week
Walking function will be evaluated twice with the C-Mill Walking Training System, before and at the end of treatment (6 weeks of treatment).
6 week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
balance
Time Frame: 6 week
Balance function will be evaluated twice, before and at the end of treatment (6 weeks of treatment), with the one-leg standing test and the functional reaching test.
6 week
Trunk control measurement scale
Time Frame: 6 week
trunk control, trunk control measurement scale will be evaluated with.
6 week
Pediatric Functional Independence Scale
Time Frame: 6 week
Independence, Pediatric Functional Independence Scale will be evaluated with.
6 week
pediatric berg balance scale
Time Frame: 6 week
The Pediatric Balance Scale is a modified version of the Berg Balance Scale that is used to assess functional balance skills in school-aged children.
6 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gazi University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 30, 2023

Primary Completion (Actual)

August 15, 2024

Study Completion (Actual)

September 15, 2024

Study Registration Dates

First Submitted

December 4, 2023

First Submitted That Met QC Criteria

December 12, 2023

First Posted (Actual)

December 14, 2023

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

December 30, 2024

Last Verified

December 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Cerebral palsy and gait

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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