The Effects of Neurodevelopmental Therapy on Feeding and Swallowing.

NCT ID: NCT04403113

Last Updated: 2020-12-08

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-30

Study Completion Date

2019-10-15

Brief Summary

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Our study is planned to investigate the effects of neck and trunk stabilization exercises, which are structured from Neurodevelopmental therapy method-Bobath concept (NDT-B) principles, on feeding and swallowing activity in children with Cerebral Palsy (CP) who take feeding and oral motor intervention strategies. The cases were divided into two groups, which is the group receiving feeding and oral motor intervention strategies+structured neck and trunk stabilization exercises (n=20) (Study Group) and those receiving feeding and oral motor intervention strategies (n=20) (Control Group).

Detailed Description

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Feeding and oral motor interventions address different aspects of feeding difficulties, reflecting the range in specific problems associated with feeding and nutrition in CP.

The trunk plays an important role in the organization of postural control and balance reactions because it holds the centre of all body mass and holds therefore, the centre of gravity. The trunk also provides stable attachment points to those muscles that control the head and neck regions. "Neck and trunk stabilization exercises" were the basis of static and dynamic balance abilities, and that increased neck and trunk stability might have had a positive effect thereon.

To achieve the alignment of the head with the trunk, the pelvis must be stabilized. This has important consequences for the entire process of swallowing. If the head is not stable, then the fine movements of the jaw and tongue needed for feeding will be impaired. With feeding and oral motor interventions and structured neck and trunk stabilization exercises, these parameters are positively affected.

Conditions

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Cerebral Palsy

Keywords

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Neck-trunk stabilization exercise. Feeding. Swallowing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Study Group (SG)

feeding and oral motor intervention strategies+structured neck and trunk stabilization exercises+caregiver training related to feeding (Study Group)

Group Type EXPERIMENTAL

Structured neck and trunk stabilization exercises

Intervention Type OTHER

Intensive structured neck and trunk stabilization exercises based on Neurodevelopmental therapy method-Bobath concept principles. These exercises were performed for 6 weeks, 2 days a week, 45 minutes for a total of 12 sessions.

Feeding and oral motor intervention strategies

Intervention Type OTHER

Feeding and oral motor intervention strategies program were performed for 6 weeks, 2 days a week, 45 minutes for a total of 12 sessions.

Caregiver training related to feeding

Intervention Type OTHER

In caregiver training related to feeding; a) positioning and feeding technique during feeding, b) ensuring safety for aspiration, c) using suitable containers and ingredients, d) adjusting (adapting) food consistency properly, e) preparing small amounts of high-calorie, balanced diet and f) reducing food spillage while feeding and how to ensure efficacy for shortening the feeding time, g) providing appropriate postural and physical support for self-feeding. All of these activities were continued for 6 weeks with a home program.

Control Group (CG).

feeding and oral motor intervention strategies+caregiver training related to feeding (Control Group)

Group Type PLACEBO_COMPARATOR

Feeding and oral motor intervention strategies

Intervention Type OTHER

Feeding and oral motor intervention strategies program were performed for 6 weeks, 2 days a week, 45 minutes for a total of 12 sessions.

Caregiver training related to feeding

Intervention Type OTHER

In caregiver training related to feeding; a) positioning and feeding technique during feeding, b) ensuring safety for aspiration, c) using suitable containers and ingredients, d) adjusting (adapting) food consistency properly, e) preparing small amounts of high-calorie, balanced diet and f) reducing food spillage while feeding and how to ensure efficacy for shortening the feeding time, g) providing appropriate postural and physical support for self-feeding. All of these activities were continued for 6 weeks with a home program.

Interventions

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Structured neck and trunk stabilization exercises

Intensive structured neck and trunk stabilization exercises based on Neurodevelopmental therapy method-Bobath concept principles. These exercises were performed for 6 weeks, 2 days a week, 45 minutes for a total of 12 sessions.

Intervention Type OTHER

Feeding and oral motor intervention strategies

Feeding and oral motor intervention strategies program were performed for 6 weeks, 2 days a week, 45 minutes for a total of 12 sessions.

Intervention Type OTHER

Caregiver training related to feeding

In caregiver training related to feeding; a) positioning and feeding technique during feeding, b) ensuring safety for aspiration, c) using suitable containers and ingredients, d) adjusting (adapting) food consistency properly, e) preparing small amounts of high-calorie, balanced diet and f) reducing food spillage while feeding and how to ensure efficacy for shortening the feeding time, g) providing appropriate postural and physical support for self-feeding. All of these activities were continued for 6 weeks with a home program.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Cases with Cerebral Palsy who had difficulties in feeding/swallowing skills.
* Cases who were cooperative without communication barriers and volunteering to participate in the study were included.

Exclusion Criteria

* In the Videoendoscopic Swallowing Study, he/she was not included in the study if he/she had an aspiration or aspiration risk, had advanced vision and hearing loss, used any pharmacological agent to inhibit spasticity, or had undergone orthopaedic surgery or Botulinum Toxin-A injection in the past six months.
Minimum Eligible Age

18 Months

Maximum Eligible Age

54 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

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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Nasim EJRAEI, Master D

Role: PRINCIPAL_INVESTIGATOR

Marmara University

Gonul Acar, Assoc. Prof

Role: STUDY_DIRECTOR

Marmara University

Locations

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Marmara University Pendik Training and Research Hospital

Istanbul, Pendik, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Acar G, Ejraei N, Turkdogan D, Enver N, Ozturk G, Aktas G. The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. Dysphagia. 2022 Aug;37(4):800-811. doi: 10.1007/s00455-021-10329-w. Epub 2021 Jun 25.

Reference Type DERIVED
PMID: 34173063 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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https://www.nature.com/articles/ejcn2013224#citeas

Feeding children with cerebral palsy and swallowing difficulties

https://www.ncbi.nlm.nih.gov/pubmed/15185730

The importance of postural control for feeding.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430291/

The effects of neck and trunk stabilization exercises on cerebral palsy children's static and dynamic trunk balance: case series

https://link.springer.com/article/10.1007/BF00260975

The objective rating of oral-motor functions during feeding

Other Identifiers

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09.2018.278

Identifier Type: -

Identifier Source: org_study_id