Effect of Vestibular Rehabilitation on Postural Sway and Energy Expenditure in Children With Spastic Diplegia

Обзор

this study will be conducted To determine the effect of vestibular rehabilitation training on postural sway and energy expenditure in children with spastic cerebral palsy and To determine any relation between postural sway and energy expenditure in children with spastic cerebral palsy.

Подробное описание

Cerebral palsy leads to postural asymmetries and balance impairments, primarily due to central vestibular dysfunction. Children aged 7-12 with gross motor function classification system levels I-III exhibit poor visual and vestibular interactions, impacting their ability to resolve sensory conflicts and manage reflexes. Excessive lateral trunk lean in cerebral palsy, prevalent in 72% of affected children, increases locomotion costs. Energy expenditure during walking rises with declining motor function, particularly in spastic cerebral palsy where vestibular dysfunction affects nearly 48% of cases. The relationship between balance control efforts and metabolic energy expenditure is complex, especially during dynamic activities like walking. This study will assess the impact of vestibular rehabilitation on postural sway and energy expenditure in children with spastic cerebral palsy, aiming to elucidate their interrelationship.

Вмешательства

• Другое vestibular rehabilitation
  * Bouncing-jumping activities from standing. * linear swinging activities: using swinging platform (standing walking) scooter activity (kneeling, standing), hanging lower limb activities and climbing swinging robe ladder. * By pushing-pulling activities, displacement of the center of gravity is created. * These are activities which enable active equilibrium on steep surfaces such as stairs. * Walking on ramps. * Walking unfamiliar surfaces such as balance disc, balance boards and balance beam
• Другое conventional physical therapy
  * Balance exercise. * Gait training (forward, backward and side way). * Gait training with obstacles of different sizes. * Gait training in stepper. * Gait training on wooden ramp. * Gait training on balance board. * Training up and down steps different heights. * Stretching exercise for upper limbs and lower limbs. * Strengthening exercises for lower limbs muscles. * Trunk control exercises like abdominal and back exercises.

Первичные конечные точки

• assessment of postural sway [Срок оценки: at base line and after 8 weeks]

Вторичные конечные точки (1)

• assessment of Energy Expenditure [Срок оценки: at base line and after 8 weeks]

Критерии участия

Критерии включения

• The age of the selected children will be ranged from 8 to 12 years old.
• Degree of spasticity is ranging from 1+to 2 according to modified Ashworth scale
• The level of motor function of the children will be levels I-II according to Gross Motor Function Classification System
• They are able to follow instructions and understand commands.

Критерии исключения

• Bone and tendon lengthening surgeries within last 6 months.
• Lung and heart diseases and disorders.
• Vision or hearing problems
• Children with fixed deformities.
• Children with epilepsy.
• Recent intramuscular Botulinum toxin injection or orthopedic surgery within last 6 months.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Египет · 1 центр

• outpatient clinic, faculty of physical therapy, Cairo university — Cairo

Идентификаторы

NCT: NCT07617935 · Nesma-phd

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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