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If a child with cerebral palsy does not develop independent sitting balance by 4 years of age, their prognosis for walking is very poor. Surprisingly little is known about how to facilitate head control or upright sitting balance and functional mobility in the child who is not developing these skills. This is one of the first studies that will examine intermediate stages in the development of the postural control system in children with neurologic deficits. Clinical researchers at The Movement Centre in Oswestry, England have developed a method called Targeted Training in which trunk control is trained in children segment by segment using a specific training device. This study aims to examine kinematic and electromyographic changes in a case series of children who undergo a 6-month Targeted Training intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single subject case series | Experimental | Targeted training, 5-6 days a week for 6 months, minimum of 20 minutes per day |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Targeted Training | Device | Custom training devices were imported from The Movement Centre for research purposes. The typical course of treatment involves loaning the customized equipment to each family for use in their home or in their child's educational setting. Training occurs once daily usually for 30-45 minutes. This is done 5 or 6 days per week. Training programs typically involve playing with balls or balloons or video games that motivate the child to hold the head erect and to wave the arms and hands and move the upper body. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Gross Motor Function Measure | 6 months and followup post training 12 months | |
| Probe data, balance | timed balance task | baseline, intervention, 2 months post intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change in head stability | Change in alignment and stability of head postural sway during quiet sitting | 6 months, 1,3, and 12 months post intervention |
| Change in muscle activation strategy during quiet sitting with different levels of external support. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sandra L Saavedra, PhD | University of Oregon | Principal Investigator |
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| ID | Term |
|---|---|
| D002547 | Cerebral Palsy |
| D000070642 | Brain Injuries, Traumatic |
| ID | Term |
|---|---|
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Gross Motor Function Measure Outcome was masked for temporal order and video scored by reviewers who were not involved in data collections or intervention.
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|
| 6 months, 1 and 3 months post intervention |
| Change in Pediatric Evaluation of Disability Inventory (PEDI) | 6 months and 1,3, 12 months post intervention |
| Qualitative Parent, Teacher report | during intervention and post intervention |
| D001930 | Brain Injuries |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |