Case Series_Targeted Training for Trunk Control Cerebral Palsy
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 2 - 12 |
| Updated: | 11/7/2018 |
| Start Date: | September 2014 |
| End Date: | May 2019 |
Effect of Targeted Training on Sensorimotor Control of Trunk Posture
Little is known about how children with cerebral palsy (CP) use their sensory systems (touch,
sense of body position, balance organs in the inner ear, vision) to help them achieve trunk
control for independent sitting. If a child with CP does not achieve trunk control by 4 years
of age their prognosis for motor skill development including walking is poor. Clinical
researchers at The Movement Centre in Oswestry, England have developed a method called
Targeted Training in which children train trunk control in small segments from the top down
using a custom fit training device. This study aims to examine how children with moderate to
severe CP use sensory information for trunk control before, during and after a program of
Targeted Training.
sense of body position, balance organs in the inner ear, vision) to help them achieve trunk
control for independent sitting. If a child with CP does not achieve trunk control by 4 years
of age their prognosis for motor skill development including walking is poor. Clinical
researchers at The Movement Centre in Oswestry, England have developed a method called
Targeted Training in which children train trunk control in small segments from the top down
using a custom fit training device. This study aims to examine how children with moderate to
severe CP use sensory information for trunk control before, during and after a program of
Targeted Training.
One of the major challenges of motor control is to understand how the central nervous system
controls the degrees of freedom of the body. This is particularly evident in cerebral palsy
(CP), which is the most prevalent chronic childhood motor disability and is one of the most
disabling and costly chronic disorders of children and adults. Deficits in postural control
and sensorimotor integration are hallmarks of CP. Although postural control of the trunk for
independent sitting creates the foundation for all other motor tasks, surprisingly little is
known about how children with CP use sensory input to guide their development of upright
control (which occurs in typically developing infants by 8 months of age). This lack of
knowledge limits our ability to effectively assess and treat children with neuromotor
deficits in trunk control.
The objectives of this project are to identify sensory reliance and sensory re-weighting in a
study of children with moderate-to-severe CP (4-12 years of age) before and after Targeted
Training for Trunk Control. A novel trunk support device will enable testing of participants
who lack (or are still developing) stable sitting. In experiments, kinematics of the head and
trunk will be measured. Sensory reliance and re-weighting will be identified from postural
trunk responses to sensory conflict stimuli consisting of tilts of a visual surround and/or
tilts of a surface which participants sit upon. Generally, participants with a high reliance
on vestibular feedback will remain upright with respect to gravity during all tests; whereas
a high reliance on cutaneous or visual feedback will produce trunk sway away from upright and
toward the surface or visual surround tilt, respectively. To tease apart biomechanical,
physical, and neurological contributions to trunk sway, sensorimotor integration modeling
will be used to complement data interpretation.
controls the degrees of freedom of the body. This is particularly evident in cerebral palsy
(CP), which is the most prevalent chronic childhood motor disability and is one of the most
disabling and costly chronic disorders of children and adults. Deficits in postural control
and sensorimotor integration are hallmarks of CP. Although postural control of the trunk for
independent sitting creates the foundation for all other motor tasks, surprisingly little is
known about how children with CP use sensory input to guide their development of upright
control (which occurs in typically developing infants by 8 months of age). This lack of
knowledge limits our ability to effectively assess and treat children with neuromotor
deficits in trunk control.
The objectives of this project are to identify sensory reliance and sensory re-weighting in a
study of children with moderate-to-severe CP (4-12 years of age) before and after Targeted
Training for Trunk Control. A novel trunk support device will enable testing of participants
who lack (or are still developing) stable sitting. In experiments, kinematics of the head and
trunk will be measured. Sensory reliance and re-weighting will be identified from postural
trunk responses to sensory conflict stimuli consisting of tilts of a visual surround and/or
tilts of a surface which participants sit upon. Generally, participants with a high reliance
on vestibular feedback will remain upright with respect to gravity during all tests; whereas
a high reliance on cutaneous or visual feedback will produce trunk sway away from upright and
toward the surface or visual surround tilt, respectively. To tease apart biomechanical,
physical, and neurological contributions to trunk sway, sensorimotor integration modeling
will be used to complement data interpretation.
Inclusion Criteria:
- cerebral palsy
- age 2-12 years
- Gross Motor Function Classification System (GMFCS) Level III, IV or V
Exclusion Criteria:
- spinal fixation
- fixed scoliosis
- uncontrolled seizures
We found this trial at
1
site
Click here to add this to my saved trials
