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The goal of this intervention study is to learn whether a physical therapy exercise camp called will improve leg movement (motor control) and functional ability in children with spastic CP who are between 5 and 18 years. The main questions the study aims to answer are:
All participants will:
Measurements:
MRI measurements will be taken twice (before and immediately after the treatment). All other measurements and will be taken 3 times (before, immediately after the treatment and approximately 4 months after the treatment).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participants who have the intervention | Experimental | physical therapy exercise intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Selective movement of individual lower limb joints | Other | Children practices moving the joints of each lower leg independently. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Gross Motor Function Measure | Children are asked to perform functional activities including standing, walking, running, balancing and stair climbing. The data are entered into a computer program to create a score ranging from 0-100. A higher score indicates better function. | nine months |
| Measure | Description | Time Frame |
|---|---|---|
| Knee joint torque | Three repetitions of maximum effort knee extension and flexion torque are collected at 0-300 deg/s for the affected lower limbs. Outcomes are the percent of knee joints that can produce measurable torque at each velocity and the peak joint torque that is produced. | nine months |
| Canadian Occupational Performance Measure |
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Inclusion Criteria:
Exclusion Criteria:
All participants
For participants undergoing MRI
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| Name | Affiliation | Role |
|---|---|---|
| Eileen G Fowler, PhD, PT | University of California, Los Angeles | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Center for Cerebral Palsy at UCLA/Orthopaedic Institute for Children | Los Angeles | California | 90095 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37142433 | Result | Vuong A, Joshi SH, Staudt LA, Matsumoto JH, Fowler EG. Improved Myelination following Camp Leg Power, a Selective Motor Control Intervention for Children with Spastic Bilateral Cerebral Palsy: A Diffusion Tensor MRI Study. AJNR Am J Neuroradiol. 2023 Jun;44(6):700-706. doi: 10.3174/ajnr.A7860. Epub 2023 May 4. |
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Outcomes assessor for GMFM was blinded.
| Knee joint strengthening at high velocities | Other | In sitting, the thigh and trunk are secured to a seat and the lower leg to a moving arm that provides resistance at exercise velocities progressing up to a maximum of 300 deg/s. |
|
| Ankle controlled gaming | Other | With the child in sitting, the ankle is secured to a moving segment. The child can control games such as tennis by dorsiflexing and plantar flexing their ankle at increasing velocities to meet the demands of the game. |
|
| Functional activities based on child and parental goals | Other | The Canadian Occupational Performance Measure is used to identify functional goals. Activities to address these goals are designed by physical therapists and practiced during camp. |
|
| Sensori-motor exercises | Other | Walking barefoot over sand and grass. Foot and ankle sensory exploration using materials with various textures. |
|
Parents/caregivers and children choose 5 activities that they would like to see improve as a result of this intervention. The parent or caregiver rates how well their child currently performs that task and how satisfied they are with the performance of the task on a scale of 1-10 with 10 being the highest score. |
| nine months |
| Brain MRI - Diffusion tensor imaging | A brain MRI scan is obtained. Tract based spatial statistics are performed from the scan to look for changes in individual voxels. Higher values for fractional anisotropy are associated with improved tract integrity. Lower values for radial and median diffusivity are associated with improved myelination. | nine months |
| ID | Term |
|---|---|
| D002547 | Cerebral Palsy |
| D009128 | Muscle Spasticity |
| ID | Term |
|---|---|
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009122 | Muscle Hypertonia |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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