Intensive Home-based Treadmill Training and Walking Attainment in Young Children With Cerebral Palsy
2020年6月18日 更新者：Katrin Mattern-Baxter、California State University, Sacramento
This study is designed to find the optimal dosage of home-based treadmill training needed to accelerate walking onset and to examine the long-term effects on the child's walking activity.
調査の概要
詳細な説明
The purpose of this study is to determine optimal parameters for dosing home-based treadmill training by comparing high-intensity (5 days/week, twice daily for 10-20 min for 6 weeks) to low-intensity (2 days/week, once daily for 10-20 minutes for 6 weeks) treadmill training; and to compare the effects of high- versus low-intensity treadmill training on walking attainment and overall walking activity in young children with cerebral palsy.
Hypotheses
- A more intensive protocol of treadmill training will increase walking onset in young children with CP.
- A more intensive protocol of treadmill training will increase overall walking activity in young children with CP.
Specific Aims
- To determine optimal parameters for dosing home-based treadmill training by comparing high-intensity to low-intensity home-based treadmill training.
- To compare the effects of high- versus low-intensity treadmill training on walking onset and overall walking activity.
Study design •Prospective randomized controlled trial
Study population
•Two groups of 12 children with CP under the age of 3 years and are not walking yet will receive either home-based high-intensity treadmill training or low-intensity treadmill training. The children will be assessed before, immediately after, at 1-month and at 4-months following the intervention via standardized outcome measures.
研究の種類
介入
入学 (実際)
19
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
-
-
Washington
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Seattle、Washington、アメリカ、98145
- Seattle Children's Research Institute
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Tacoma、Washington、アメリカ、98416
- University of the Puget Sound
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-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
1年～3年 (子)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- Signs of walking readiness as demonstrated by the ability to sit for 30 seconds when placed and to take 5 to 7 steps when supported at the trunk or arms.
Because young children often are not formally diagnosed with CP until 2 years of age, we will include children
- who show bilateral impairment (i.e. diplegia and quadriplegia, but not hemiplegia)
- who demonstrate upper motor neuron signs (i.e. spasticity and/or hyperreflexia)
- who have been identified as high-risk for a motor disability by a physician
Exclusion Criteria:
- a history of uncontrolled seizures
- a diagnosis of a genetic disorder
- cardiac or orthopedic contraindications for standing and walking
- orthopedic surgery in the past 6 months
- use of spasticity-reducing medication or Botox injections in the past 6 months
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ：high-intensity group
Children will engage in home-based treadmill training 5 days/week, twice daily for 10-20 min for 6 weeks
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the child will walk on a pediatric treadmill with the help of the parent/caregiver and with weekly supervision of a physical therapist
|
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アクティブコンパレータ：low-intensity group
Children will engage in home-based treadmill training 2 days/week, once daily for 10-20 minutes for 6 weeks
|
the child will walk on a pediatric treadmill with the help of the parent/caregiver and with weekly supervision of a physical therapist
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Gross Motor Function Measure Dimension E
時間枠：assessed at 6 weeks, 1 month, 4 months from baseline
|
The Gross Motor Function Measure is a criterion-referenced test of gross motor function for children with cerebral palsy ages 5 months to 15 years.
It contains 5 Dimensions (A-E).
Dimension E is related to the child's gross motor skills related to walking, running and jumping and is assessed by observation.
Dimension E contains 24 gross motor skills.
Each of these motor skills is rated either 0 (does not initiate), 1(initiates), 2 (partially completes), 3 (completes) or NT( not tested).
The total possible Dimension E score is 72 with a range of 0-72.
Scores can be converted into a percent score by dividing the child's achieved points by the number of possible points.
Higher scores and a higher percentage indicate better performance in walking, running and jumping.
Change from baseline in total points, not in percentage, is reported.
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assessed at 6 weeks, 1 month, 4 months from baseline
|
|
Walking Activity Measured by StepWatch
時間枠：StepWatch data was collected for all awake daytime hours over a 7 day period at study onset before treadmill training commences and at 6 weeks, 1 month, 4 months.
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StepWatch data records the child's walking activity in minutes/day.
It is collected via an accelerometer attached to the distal leg and worn at all waking hours except during sleep and bath time.Higher numbers of active minutes indicate higher level of activity.
Changes from baseline are reported.
|
StepWatch data was collected for all awake daytime hours over a 7 day period at study onset before treadmill training commences and at 6 weeks, 1 month, 4 months.
|
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Gross Motor Function Measure Dimension D
時間枠：assessed at 6 weeks, 1 month, 4 months from baseline
|
The Gross Motor Function Measure is a criterion-referenced test of gross motor function for children with cerebral palsy ages 5 months to 15 years.
It contains 5 Dimensions (A-E).Dimension D is a test of gross motor function related to standing ability.
The child's gross motor skills related to standing are assessed by observation.
The test contains 13 gross motor skills.
Each of these motor skills is rated either 0 (does not initiate), 1(initiates), 2 (partially completes), 3 (completes) or NT( not tested).
The total possible Dimension D score is 39 with a range of 0-39.
Scores can be converted into a percent score by dividing the child's achieved points by the number of possible points.
Higher scores and a higher percentage indicate better performance in standing.
Change from baseline in total points, not in percentage, is reported.
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assessed at 6 weeks, 1 month, 4 months from baseline
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Pediatric Evaluation of Disability Index-Mobility Subscale
時間枠：pre-intervention, at 6 weeks, at 1-month and at 4-months following the intervention
|
The Pediatric Evaluation of Disability Index is a valid and reliable tool that provides an assessment of a child's functional status and performance via observation and parent report.The Mobility Subscale examines the child's functional skills related to movement.
There are a total of 13 motor categories on the Mobility Subscale, with 5 possible motor skills in each category, for a total of 65 distinct motor skills.
Skills are marked as 0 (not observed) or 1 (observed) and added.There are a total of 65 possible points with a range of 0-65 points on the Mobility Subscale.
Higher scores indicate greater function.Scores are reported as changes from baseline.
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pre-intervention, at 6 weeks, at 1-month and at 4-months following the intervention
|
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Timed 10-meter Walk Test
時間枠：assessed at 6 weeks, at 1-month and at 4-months following the intervention
|
The child's walking speed is recorded over 10 meters if the child is able to walk with or without an assistive device.
The speed is timed and reported in seconds.
Fewer seconds indicate a faster walking speed.
Time in seconds is reported as change from baseline.
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assessed at 6 weeks, at 1-month and at 4-months following the intervention
|
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Peabody Developmental Motor Scales-2 -Locomotion Subscale
時間枠：assessed at 6 weeks, at 1-month and at 4-months
|
Peabody Developmental Motor Scales-2 is a norm-referenced standardized test of gross and fine motor performance for children from birth through age 5.The Locomotion Subscale examines the ability of the child to move through space.
It contains a total of 89 motor skills.
The child is rated on each skill on a scale of 0 (unable), 1 (partial) or 2 (complete) and the scores are added for a total possible raw score of 178 and a range of 0-178.
Higher raw scores indicate a better outcome.The raw scores can be converted to standard scores, age equivalents and percentiles Raw scores of the Locomotion subscale are reported based on changes from baseline.
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assessed at 6 weeks, at 1-month and at 4-months
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1-minute Walk Test
時間枠：assessed at 6 weeks, 1 month, 4 months
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The child's walking distance is measured in meters over 1 minute at their self-selected walking speed if the child is able to walk with or without an assistive device.The walking distance is reported in meters.
More meters indicate more distance covered.
Values are reported in meters as changes from baseline.
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assessed at 6 weeks, 1 month, 4 months
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- スタディディレクター：David Earwicker, BA,MA、California State University, Sacramento
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2015年7月1日
一次修了 (実際)
2018年9月1日
研究の完了 (実際)
2018年9月1日
試験登録日
最初に提出
2015年4月16日
QC基準を満たした最初の提出物
2015年4月22日
最初の投稿 (見積もり)
2015年4月23日
学習記録の更新
投稿された最後の更新 (実際)
2020年7月2日
QC基準を満たした最後の更新が送信されました
2020年6月18日
最終確認日
2020年6月1日
詳しくは
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