Effect of the Nutritional Support System on Neuromotor Alterations in Patients With Cerebral Palsy

NCT ID: NCT05648422

Last Updated: 2023-02-01

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

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-16

Study Completion Date

2025-01-31

Brief Summary

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Study to determine the impact of a nutritional support system (NSS) on neuromotor alterations in patients with cerebral palsy.

Detailed Description

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Cerebral Palsy (CP) is a group of motor disorders of the brain and can be accompanied by alterations in sensation, perception, cognition, communication and behavior, epilepsy and secondary musculoskeletal disorders. These disorders decrease daily functional performance in the areas of mobility, cognition and self-care, resulting in the need for a primary caregiver and increased health care costs. Rehabilitative treatment to increase functional independence is taken from the point of view of motor function (physiotherapy), however, no emphasis is placed on nutritional treatment aimed at alterations in mobility, cognition and self-care; currently it has been observed that eating disorders alter neuromuscular function directly or indirectly, therefore many patients do not respond adequately to treatment due to deterioration in secondary nutritional status. Dietary deficiency in patients with ICH is the result of the lack of an essential nutrient in the diet, each of these nutrients has a functional dynamic in the different stages, so that if one of them is missing or deficient, a functional or organic alteration, a biochemical variation or a disorder in body mass will occur. The World Health Organization (WHO) only considers energy, protein and fat requirements according to the age of the child. The NSS (Nutritional Support System) consisting of specific diet, supplementation (glutamine, arginine, folic acid, PUFA-n3, vegetal protein, nicotinic acid, cobalamin, thiamine, pyridoxine, magnesium, zinc, selenium, cholecalciferol, resveratrol, ascorbic acid, Spirulina Máxima, and inuline) and probiotics, have individually demonstrated effects such as neuronal regeneration, neuroprotective effect, reduction of oxidative stress.

A randomized, blinded, clinical trial will be conducted in children aged 4 to 11 years with CP functional level III of the Gross Motor Function Classification System (GMFCS), without impaired cognitive status and unable to walk on their own. They are randomly assigned to three groups: 1) follow-up group (GS) to which conventional diet (WHO) be applied; 2) control group 2 (GC) to which conventional diet (WHO), deworming and probiotics will be applied 3) intervention group (GI) deworming, probiotics, NSS supplements and specific diet will be applied, they will be followed up for three months; They will be evaluated at baseline, week 7 and week 13 with Gross Motor Function Measure 66 (GMFM-66) and MACS; at baseline and week 13 with kinetics and kinematic analysis, and electromyography (EMG). Statistical analysis: For the intragroup inferential statistical analysis, 2-way ANOVA will be used if the distribution is normal, otherwise FRIEDMAN will be used, in both cases post hoc tests will be applied; for the intergroup analysis, 1-way ANOVA will be used if the distribution is normal, otherwise KRUSKAL WALLIS will be used, in both cases post hoc tests will be applied.

Conditions

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Cerebral Palsy Spastic Malnutrition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Randomized, controlled clinical trial with blinding.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors
The outcomes assessors and care providers had no access to any information about the treatment administered to each child, which ensured compliance with the blinded portion of the study.

Study Groups

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FG (FOLLOW GROUP)

FG receive: Conventional diet (WHO).

Group Type NO_INTERVENTION

No interventions assigned to this group

CG (CONTROL GROUP)

CG receive: Conventional diet (WHO), deworming (nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days), and probiotics (Saccharomyces Boulardii, 200 mg every 12 hours for 6 days at week 1, 5 and 9).

Group Type EXPERIMENTAL

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Saccharomyces Boulardii 200 mg every 12 hours for 6 days at week 1, 5 and 9

Deworming

Intervention Type DRUG

nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days

Conventional diet (WHO)

Intervention Type OTHER

This diet focuses on meeting caloric needs according to age, weight, height, and stress factor dividing total caloric value in 50% carbohydrates, 30% lipids, and 20% proteins. It consists of general nutricional recommendations.

IG (INTERVENTION GROUP)

IG receive: Deworming (nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days), probiotics (Saccharomyces Boulardii, 200 mg every 12 hours for 6 days at week 1, 5 and 9), specific diet, and NSS envelope (glutamine, arginine, folic acid, PUFA-n3, vegetal protein, nicotinic acid, cobalamin, thiamine, pyridoxine, magnesium, zinc, selenium, cholecalciferol, resveratrol, ascorbic acid, Spirulina Máxima, and inuline) every 12 hours for 12 weeks.

Group Type EXPERIMENTAL

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Saccharomyces Boulardii 200 mg every 12 hours for 6 days at week 1, 5 and 9

NSS Nutritional Support System

Intervention Type DIETARY_SUPPLEMENT

Nutritional Support System consists in NSS envelope (glutamine, arginine, folic acid, PUFA-n3, vegetal protein, nicotinic acid, cobalamin, thiamine, pyridoxine, magnesium, zinc, selenium, cholecalciferol, resveratrol, ascorbic acid, Spirulina Máxima, glycine, tryptophan, and inuline) every 12 hours for 12 weeks.

Deworming

Intervention Type DRUG

nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days

Specific diet

Intervention Type OTHER

This diet focuses on meeting caloric needs according to age, weight, height, and stress factor dividing total caloric value in 50% carbohydrates, 30% lipids, and 20% proteins. It consists of smoothies at breakfast and dinner, high consumption of fish, five meals during the day, 70% of meals eaten during the day will consist on vegetables, fruits, roots, cereals, and legumes. Red meat, gluten, lactose, junk food, sugar, salt, fast food free.

Interventions

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Probiotics

Saccharomyces Boulardii 200 mg every 12 hours for 6 days at week 1, 5 and 9

Intervention Type DIETARY_SUPPLEMENT

NSS Nutritional Support System

Nutritional Support System consists in NSS envelope (glutamine, arginine, folic acid, PUFA-n3, vegetal protein, nicotinic acid, cobalamin, thiamine, pyridoxine, magnesium, zinc, selenium, cholecalciferol, resveratrol, ascorbic acid, Spirulina Máxima, glycine, tryptophan, and inuline) every 12 hours for 12 weeks.

Intervention Type DIETARY_SUPPLEMENT

Deworming

nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days

Intervention Type DRUG

Specific diet

This diet focuses on meeting caloric needs according to age, weight, height, and stress factor dividing total caloric value in 50% carbohydrates, 30% lipids, and 20% proteins. It consists of smoothies at breakfast and dinner, high consumption of fish, five meals during the day, 70% of meals eaten during the day will consist on vegetables, fruits, roots, cereals, and legumes. Red meat, gluten, lactose, junk food, sugar, salt, fast food free.

Intervention Type OTHER

Conventional diet (WHO)

This diet focuses on meeting caloric needs according to age, weight, height, and stress factor dividing total caloric value in 50% carbohydrates, 30% lipids, and 20% proteins. It consists of general nutricional recommendations.

Intervention Type OTHER

Other Intervention Names

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Probiotics (Saccharomyces Boulardii) NSS Nitazoxanide

Eligibility Criteria

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Inclusion Criteria

* Patients with GMFCS III classification.
* Patients with spastic CP.
* Both sexes age 4 to 11 years.
* Primary caregiver engaged (full presence).
* Able to follow instructions.
* Tolerant to oral feeding.
* Parents or guardians to sign informed consent letter.
* Children, if able to write, sign the letter of assent.

Exclusion Criteria

* Have received antibiotics 15 days prior to treatment.
* Having received botulinum toxin therapy in the last six months. Consumption of muscle relaxants in the last three months.
* Patient with any type of surgery in a period of less than 6 months.
* Presence of any other catabolic disease, which further increases their risk of malnutrition (renal, cardiovascular, pulmonary, hepatic, immunological).
* Intolerance to oral feeding.
* Lack of stimulation at home.
* Moderate to severe gastroesophageal reflux.
* Able to walk without support.
Minimum Eligible Age

4 Years

Maximum Eligible Age

11 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Anahuac University

OTHER

Sponsor Role lead

Responsible Party

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Fernando Leal-Martinez

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fernando Leal, PhD

Role: STUDY_DIRECTOR

Anahuac University

Locations

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Apac I.A.P. (Association For People With Cerebral Palsy)

México, , Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Fernando Leal, PhD

Role: CONTACT

5521094339

Facility Contacts

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Fernando Leal-Martínez, PhD

Role: primary

5521094339

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Other Identifiers

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202082

Identifier Type: -

Identifier Source: org_study_id

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