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The study aims at comparing Neuromuscular electrical Stimulation with and without dynamic bracing on spasticity and movement quality of lower limb in Children with Cerebral Palsy
Cerebral palsy (CP) is a lifelong motor impairment caused by an early brain injury and affects 2-3 per 1,000 live births. It is a complex medical condition that negatively impacts cognition, language, sensations, movement, and gait patterns. It is normally carried out using a comprehensive approach that incorporates numerous approaches targeted at minimizing symptoms and improving functional outcomes.
NMES (Neuromuscular and Muscular Electrical Stimulation) is an instrument that provides electrical impulses to nerves, causing muscles to contract, while dynamic bracing use muscle power to pre-compress soft tissue to produce the high forces required to control specific pathological diseases.
The hip adductors, the knee flexor muscles, and the ankle and foot muscles (gastrocnemius and soleus may experience increased tone, causing the ankles to be held in a plantar-flexed (pointed downward) position) are targeted with NMES in the lower extremity to reduce the spasticity & improve the quality of movement in CP children. Investigating how combining NMES with dynamic bracing benefits lumbar disc bulge patients adds to the growing body of evidence supporting multimodal treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NMES with Dynamic Bracing | Experimental | The NMES targeting the hip adductors, the knee flexor muscles and the ankle & foot muscles, along with dynamic bracing |
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| NMES without Dynamic Bracing | Experimental | Neuromuscular Electrical Stimulator targeting the lower extremity |
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| Dynamic Bracing Only | Experimental | Dynamic Bracing of lower extremity |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NMES with Dynamic Bracing | Other | The group will receive NMES along with dynamic bracing |
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| Measure | Description | Time Frame |
|---|---|---|
| Modified Ashworth Scale | The scale is used to measure spasticity minimum score is 0 and maximum score is 4 | baseline and 6 weeks |
| Observable Movement Quality Scale | it is used assess the movement quality in children Minimum Score: 0 (indicating the poorest movement quality) and maximum is 24 | baseline and 6 weeks |
| Physicians Rating Scale | it is used to objectively documenting the hip, knee, ankle and foot changes in children with CP. Minimum Score: 0 (indicating no impairment or lowest severity) and Maximum score is 7 | baseline and 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ayesha Ashraf, MS NMPT* | Ripha International Univerisity | Principal Investigator |
| Ammara Abbas, tDPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children Hospital | Faisalābad | Punjab Province | 54000 | Pakistan |
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| ID | Term |
|---|---|
| C537945 | Cerebral palsy, spastic, diplegic |
| D002547 | Cerebral Palsy |
| ID | Term |
|---|---|
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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participants and outcome assessors will be kept blind about the intervention which the patients will be receiving
| NMES without Dynamic Bracing | Other | The participants will receive NMES on the lower extremity |
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| Dynamic Bracing Only | Other | This group will receive dynamic bracing only on the lower limb. |
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