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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.

研究概览

详细说明

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.

研究类型

介入性

注册 (实际的)

19

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Washington
      • Seattle、Washington、美国、98145
        • Seattle Children's Research Institute
      • Tacoma、Washington、美国、98416
        • University of the Puget Sound

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

1年 至 3年 (孩子)

接受健康志愿者

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
有源比较器:high-intensity group
Children will engage in home-based treadmill training 5 days/week, twice daily for 10-20 min 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
有源比较器: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

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Gross Motor Function Measure Dimension E
大体时间: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.
assessed at 6 weeks, 1 month, 4 months from baseline
Walking Activity Measured by StepWatch
大体时间: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.
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.
Gross Motor Function Measure Dimension D
大体时间: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.
assessed at 6 weeks, 1 month, 4 months from baseline

次要结果测量

结果测量
措施说明
大体时间
Pediatric Evaluation of Disability Index-Mobility Subscale
大体时间: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.
pre-intervention, at 6 weeks, at 1-month and at 4-months following the intervention
Timed 10-meter Walk Test
大体时间: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.
assessed at 6 weeks, at 1-month and at 4-months following the intervention
Peabody Developmental Motor Scales-2 -Locomotion Subscale
大体时间: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.
assessed at 6 weeks, at 1-month and at 4-months
1-minute Walk Test
大体时间:assessed at 6 weeks, 1 month, 4 months
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.
assessed at 6 weeks, 1 month, 4 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 研究主任:David Earwicker, BA,MA、California State University, Sacramento

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2015年7月1日

初级完成 (实际的)

2018年9月1日

研究完成 (实际的)

2018年9月1日

研究注册日期

首次提交

2015年4月16日

首先提交符合 QC 标准的

2015年4月22日

首次发布 (估计)

2015年4月23日

研究记录更新

最后更新发布 (实际的)

2020年7月2日

上次提交的符合 QC 标准的更新

2020年6月18日

最后验证

2020年6月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

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