Development of Simulated Hippotherapy System and Investigation of Its Effectiveness in Children With Cerebral Palsy

NCT ID: NCT03889262

Last Updated: 2019-03-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-01

Study Completion Date

2019-09-20

Brief Summary

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The purpose of this study is to develop a simulated hippotherapy system controlled by electromyography (EMG) signals and investigate its effectiveness in children with cerebral palsy. In order to investigate its effectiveness evaluation of gross motor functions, lower extremity joint movements, spasticity of the lower extremities, functional independence, body movements, sitting and standing balance, muscle tone, stiffness and elasticity level, analysis of the walking are planned.

Detailed Description

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Hippotherapy is a therapeutic method in which a real horse is used for therapeutic purposes. It is widely used in many countries in the treatment of neuromuscular diseases (Multiple Sclerosis, stroke, Cerebral Palsy, etc.). Although the use of hippotherapy is widespread, many people can not reach and use this method effectively because of many reasons such as the high cost of caring, feeding, and sheltering horses or fear of people from horses. In recent years, hippotherapy simulation devices (mechanic and robotic horses) have been developed to overcome these problems. These devices aim to create the effects of hippotherapy on people by simulating a real horse's movement. The aim of this project is to develop and produce a simulated hippotherapy system, which can be controlled by electromyography (EMG) signals coming from the rider, movements programmable (for different musculoskeletal problems), rehabilitation-specific, providing evaluation during therapy, integrating virtual reality system and therapy games and investigate its effectiveness in children with cerebral palsy.

Conditions

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Cerebral Palsy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control Group

Participants in this group will receive only Neurodevelopmental therapy (NDT) based rehabilitation for 45 minutes in each session, twice a week, during 8 weeks, 16 sessions in total. Number of participants in this group is anticipated to be 20.

Group Type ACTIVE_COMPARATOR

Neurodevelopmental Therapy

Intervention Type OTHER

Neurodevelopmental therapy (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language pathologists. NDT was developed to enhance the function of children who have difficulty controlling movement as a result of neurological challenges, such as cerebral palsy and head injury. During treatment interventions, repeated experience in movement ensures that a particular pattern is readily accessible for motor performance. The more a patient performs certain movements, the easier these movements becomes.

Study Group

After 16 sessions (8 weeks) of only Neurodevelopmental therapy (NDT) based rehabilitation, simulated hippotherapy treatment will be added to rehabilitation program of the same participants. Their NDT treatment will be reduced to 25 minutes whereas hippotherapy will be applied for 20 minutes in each session, 2 sessions a week, 8 weeks in total.

Group Type ACTIVE_COMPARATOR

Hippotherapy

Intervention Type OTHER

Hippotherapy is a therapeutic method in which a mechanical horse is used for therapeutic purposes.

Neurodevelopmental Therapy

Intervention Type OTHER

Neurodevelopmental therapy (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language pathologists. NDT was developed to enhance the function of children who have difficulty controlling movement as a result of neurological challenges, such as cerebral palsy and head injury. During treatment interventions, repeated experience in movement ensures that a particular pattern is readily accessible for motor performance. The more a patient performs certain movements, the easier these movements becomes.

Interventions

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Hippotherapy

Hippotherapy is a therapeutic method in which a mechanical horse is used for therapeutic purposes.

Intervention Type OTHER

Neurodevelopmental Therapy

Neurodevelopmental therapy (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language pathologists. NDT was developed to enhance the function of children who have difficulty controlling movement as a result of neurological challenges, such as cerebral palsy and head injury. During treatment interventions, repeated experience in movement ensures that a particular pattern is readily accessible for motor performance. The more a patient performs certain movements, the easier these movements becomes.

Intervention Type OTHER

Other Intervention Names

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Bobath Therapy

Eligibility Criteria

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Inclusion Criteria

* Having a diagnosis of Spastic Cerebral Palsy,
* Children aged between 5 - 18 years,
* Gross motor functional level is I, II or III,
* Independent seating
* Walking at least 10 meters independently,
* Can understand simple verbal instructions,
* Those with a spasticity level less than 2 according to Modified Ashworth Scale ,
* Having bilateral hip abduction enough to sit on the hippotherapy device,
* Voluntary acceptance to participate in the study

Exclusion Criteria

* Having hip dislocation,
* Severe contracture or deformity,
* Scoliosis (above 20 degrees),
* Acute uncontrolled acute seizures,
* Epilepsy,
* Visual and auditory problems,
* Injection of botulinum toxin in the last 6 months,
* History of surgical operation such as muscle relaxation, tendon extension and selective dorsal rhizotomy in the last 6 months.
Minimum Eligible Age

5 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Marmara University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Zubeyir Sarı

Role: STUDY_DIRECTOR

Marmara University Institute of Health Sciences

Central Contacts

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Neslihan Karabacak

Role: CONTACT

+905347474980

Canan Günay Yazıcı

Role: CONTACT

+905384601249

References

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Han JY, Kim JM, Kim SK, Chung JS, Lee HC, Lim JK, Lee J, Park KY. Therapeutic effects of mechanical horseback riding on gait and balance ability in stroke patients. Ann Rehabil Med. 2012 Dec;36(6):762-9. doi: 10.5535/arm.2012.36.6.762. Epub 2012 Dec 28.

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Herrero P, Gomez-Trullen EM, Asensio A, Garcia E, Casas R, Monserrat E, Pandyan A. Study of the therapeutic effects of a hippotherapy simulator in children with cerebral palsy: a stratified single-blind randomized controlled trial. Clin Rehabil. 2012 Dec;26(12):1105-13. doi: 10.1177/0269215512444633. Epub 2012 May 18.

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Kim SG, Lee JH. The effects of horse riding simulation exercise on muscle activation and limits of stability in the elderly. Arch Gerontol Geriatr. 2015 Jan-Feb;60(1):62-5. doi: 10.1016/j.archger.2014.10.018. Epub 2014 Nov 7.

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Kim SK, Kim SG, HwangBo G. The effect of horse-riding simulator exercise on the gait, muscle strength and muscle activation in elderly people with knee osteoarthritis. J Phys Ther Sci. 2017 Apr;29(4):693-696. doi: 10.1589/jpts.29.693. Epub 2017 Apr 20.

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Lee DR, Lee NG, Cha HJ, Yun Sung O, You SJ, Oh JH, Bang HS. The effect of robo-horseback riding therapy on spinal alignment and associated muscle size in MRI for a child with neuromuscular scoliosis: an experimenter-blind study. NeuroRehabilitation. 2011;29(1):23-7. doi: 10.3233/NRE-2011-0673.

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Reference Type BACKGROUND
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Park JH, Shurtleff T, Engsberg J, Rafferty S, You JY, You IY, You SH. Comparison between the robo-horse and real horse movements for hippotherapy. Biomed Mater Eng. 2014;24(6):2603-10. doi: 10.3233/BME-141076.

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Provided Documents

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Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

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09.2017.297

Identifier Type: -

Identifier Source: org_study_id

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