Exercise Training on a Mirror for Intermittent Exotropia Control Post Strabismus Surgery

Exercise Training in Front of a Mirror for Intermittent Exotropia Control Post Strabismus Surgery: A Randomized Controlled Study

The study aims to explore the impact of mirror therapy on exodeviation control, near and far strabismus angles, and quality of life in intermittent exotropia control post strabismus surgery, as well as its effects on near and far strabismus angles.

Study Overview

• Status: Not yet recruiting
• Conditions: Strabismus; Exercise Training; Intermittent Exotropia
• Intervention / Treatment: Other: mirror therapy; Other: traditional therapy

Detailed Description

Strabismus is a common childhood disorder causing eye deviation, affecting life quality and cosmetic appearance. Early detection and management improve binocular function and psychosocial problems. Intermittent exotropia is a common type. Surgery is the most common method for correcting strabismus, but complications can be difficult to treat. Physical therapy programs are limited in treating strabismus after surgery, and adding mirror therapy to traditional treatments may help maintain surgery results. This thesis aims to decrease this knowledge gap and improve the treatment of strabismus.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nesma Nawwar Abdallah khattab, physical therapist; Phone Number: 01286914661; Email: nesma.khattab2020@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. 40 boys and girls with ages from 5 to 15 years
2. History of strabismus surgery from 6 months presence of intermittent exotropia.
3. Normal sensory and motor fusion, equal visual acuity. Good general health condition.
4. Ability to understand and do the exercises at home

Exclusion Criteria:

1. systemic diseases as myasthenia gravis, multiple sclerosis and diabetes
2. Optic nerve injury, organic ocular disease, attention disorder and mental disorders
3. Attention disorder and learning disability

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
Experimental: Mirror therapy; It will include 20 patients. They will receive traditional physical therapy exercise using mirror therapy twice a week ,for 3 months ,and subjects will do the same exercise at home daily with the aid of mother and level of adherence will be checked every session	Other: mirror therapy; Participants will undergo physiotherapy exercises in a mirror alongside post-surgery care. The program includes palming exercises, eye exercises, pencil push-ups, Brock string exercises, thumb exercises, and proprioceptive neuromuscular facilitation exercises. The first exercise warms up extra ocular muscles, the second improves eye coordination, the third motivates the lazy eye, the fourth strengthens eye muscles, and the fifth involves a near-distance jump for oblique muscles.
Active Comparator: Traditional therapy; It will include 20 patients. They will receive traditional physical therapy exercise only twice a week ,for 3 months ,and subjects will do the same exercise at home daily with the aid of mother and level of adherence will be checked every session	Other: traditional therapy; The patients within the control group will receive traditional care post-strabismus operation as eye glasses and eye drops and regular exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of change of the exodeviation control	The ophthalmologist examines participants' eyes while focusing on an accommodative target, determining their exotropia score. The scores range from constant to dissociated, with no exotropia unless dissociated and maximum score is 5 and minimal score is 0. the lower score is the better	at baseline and after 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of change of the near strabismus angles	the near strabismus angles will be measured by using prisms of different powers	at baseline and after 3 months
Assessment of change of the far strabismus angles	The prism cover test is a method used to measure the angle of deviation of a small-angle tropia. It involves covering the non-fixating eye with a prism oriented in the same direction as the deviation, blocking the fixating eye simultaneously. The strength of the prism is adjusted to prevent fixation shift and reduce deviation. Near and far strabismus angles are measured using prisms of varying powers. The measurement should be taken at 33 cm, 6 m, and occasionally at 60 m, and with or without corrective lenses.	at baseline and after 3 months
Assessment of change of questions of Child and Proxy health related quality of life	The final Child and Proxy health-related quality of life questionnaires for intermittent exotropia are designed to gather information about the concerns and difficulties faced by children and adolescents with this condition. The questionnaires are formatted for 5-7-year-old children, 8-17-year-old children, and PROXY children.	at baseline and after 3 months
Assessment of change of questions of health-related quality of life questionnaire for Parents of children with intermittent exotropia	Parents of children with intermittent exotropia often express concerns about their child's eyesight, including potential physical and psychological effects.	at baseline and after 3 months

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2025
• Primary Completion (Estimated): April 1, 2025
• Study Completion (Estimated): May 1, 2025

Study Registration Dates

• First Submitted: December 23, 2024
• First Submitted That Met QC Criteria: January 4, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 4, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Eye Diseases; Cranial Nerve Diseases; Ocular Motility Disorders; Exotropia; Strabismus
• Other Study ID Numbers: Nesma-005418

Drug and device information, study documents

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