Neural Mobilization and Cerebral Palsy

NCT ID: NCT06485830

Last Updated: 2024-12-06

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

RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-10

Study Completion Date

2025-06-15

Brief Summary

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Objective: To assess the effect of neural mobilization applied to the lower limbs, compared to conventional physical therapy, in children diagnosed with Cerebral Palsy. Using the International Classification of Functioning, Disability and Health, the investigators will try to evaluate the impact of the intervention in aspects related with structure, activity, and participation.This project will mainly focus on the structure dimension. More specifically, the investigators aim to observe if a treatment protocol designed to modify the structure (e.g.,the sciatic nerve using neural mobilization techniques), will evoke changes not only in the structural dimension, but also will be able to modify the activity and participation dimensions.

Design: A single blinded randomized clinical trial (the evaluator will remain blinded to treatment allocation group) will be conducted. The experimental group will receive an intervention consisting on the use of neurodynamic mobilization procedures of the lower limb and participants in the control group will undergo a conventional physical therapy intervention (stretching, mobilization), without the use of neural mobilization.

Subjects: Participants will be aged between 5 and 18 years, and with a confirmed diagnosed of Cerebral Palsy with the presence of spasticity in the lower limbs.

Methods: Participants will be randomly allocated into two groups: experimental or control group. The primary outcome will be the range of motion (flexion and extension) of the hip, knee and ankle. Secondary outcomes will include gross motor function, pain intensity, muscle stiffness, muscle tension, and functional measures.

Detailed Description

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Conditions

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Cerebral Palsy Neurologic Disorder

Keywords

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range of motion pain intensity gross motor function neural mobilisation quality of life muscle stiffness muscle tension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Sealed opaque envelopes will be used for treatment allocation. The research in charge of collecting the outcome measures will remained unaware of treatment allocation group

Study Groups

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Neural mobilization of the lower limb

Several neural mobilization techniques will be performed for the lower limb, with a special focus on the sciatic nerve. First, three different passive techniques will be used. These will consist of two sets of ten repetitions each with one minute rest between sets. This will last approximately 5 minutes. Then, three dynamic neural mobilization techniques will be performed, with each exercise lasting for 5 minutes per set, including two different sets (one minute rest between them), with a total of 10 minutes of mobilization and one minute of rest per exercise. Therefore the complete approach will last for 30 minutes approximately. Following this set of dynamic neural mobilization exercises, static neural mobilizations of the sciatic nerve will be performed again following the same order and duration than in the beginning.

Group Type EXPERIMENTAL

Neural mobilization of the lower limb

Intervention Type PROCEDURE

Static neural mobilization techniques will be performed for the lower limb. Static procedures will consist of two sets of 10 repetitions, with one minute rest between sets. Next, dynamic neural mobilization techniques will be performed, with each exercise lasting 5 minutes per set, with one minute rest between them. Therefore, dynamic procedures will consist of 10 minutes per mobilization technique (with one minute rest between exercises).

At the end of all dynamic mobilization exercises, static mobilizations of the sciatic nerve will be performed again in the same order and with the same duration.

The intervention will consist of a total of 8 sessions (either twice a week for four weeks or once a week for a total of 8 weeks). This will depend on the participant usual attendance to his/her treatment center

Conventional physiotherapy treatment

A conventional treatment will be performed, consisting of passive and active mobilizations, active stretching, and techniques aimed at improving daily life activities

Group Type ACTIVE_COMPARATOR

Conventional physical therapy

Intervention Type PROCEDURE

The intervention will include a first part in which active mobilizations, active-assisted mobilizations, and active stretches will be performed, followed by activities aimed at improving physical training, mobility training, and strength training oriented towards specific tasks. After this second part, the first part will be repeated in the same order and duration.

The intervention will consist of a total of 8 sessions (either twice a week for four weeks or once a week for a total of 8 weeks). This will depend on the participant usual attendance to his/her treatment center

Interventions

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Neural mobilization of the lower limb

Static neural mobilization techniques will be performed for the lower limb. Static procedures will consist of two sets of 10 repetitions, with one minute rest between sets. Next, dynamic neural mobilization techniques will be performed, with each exercise lasting 5 minutes per set, with one minute rest between them. Therefore, dynamic procedures will consist of 10 minutes per mobilization technique (with one minute rest between exercises).

At the end of all dynamic mobilization exercises, static mobilizations of the sciatic nerve will be performed again in the same order and with the same duration.

The intervention will consist of a total of 8 sessions (either twice a week for four weeks or once a week for a total of 8 weeks). This will depend on the participant usual attendance to his/her treatment center

Intervention Type PROCEDURE

Conventional physical therapy

The intervention will include a first part in which active mobilizations, active-assisted mobilizations, and active stretches will be performed, followed by activities aimed at improving physical training, mobility training, and strength training oriented towards specific tasks. After this second part, the first part will be repeated in the same order and duration.

The intervention will consist of a total of 8 sessions (either twice a week for four weeks or once a week for a total of 8 weeks). This will depend on the participant usual attendance to his/her treatment center

Intervention Type PROCEDURE

Other Intervention Names

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Neurodynamics Usual care

Eligibility Criteria

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Inclusion Criteria

* Children and adolescents diagnosed with Cerebral Palsy or presence of spasticity and aged between 5 and 18 years.
* Level I to V in the Gross Motor Function Classification System, which denotes that the participant should be able to walk with or without using assistive devices.
* Increased muscle tone in the lower extremities, represented by a score greater than 0 on the Tardieu clinical scale and a positive response in the Duncan Ely test.
* Ability to communicate pain.
* Ability to follow simple commands.

Exclusion Criteria

* Have ankle joint arthrodesis or any surgical operation that prevents joint mobilization of the lower limb to some degree.
* Any significant change in medication treatment during the study period that may influence (increase or decrease) muscle tone.
* Experience uncontrolled epileptic seizures despite medication.
* Have received botulinum toxin treatment in the lower limb within the 6 months prior to the study.
* Undergo a different physical therapy treatment parallel to that developed in the study.
Minimum Eligible Age

5 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto de Biomedicina (IBiS) de Sevilla

UNKNOWN

Sponsor Role collaborator

University of Seville

OTHER

Sponsor Role lead

Responsible Party

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Alberto Marcos Heredia-Rizo

University Full Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alberto M. Heredia Rizo, PhD

Role: STUDY_DIRECTOR

Instituto de Biomedicina (IBiS) de Sevilla

Locations

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Centro de Atencion Infantil Temprana (CAIT), Universidad de Cordoba

Córdoba, Cordoba, Spain

Site Status RECRUITING

University of Sevilla

Seville, Sevilla, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Ramon Gonzalez Matilla, MSc.

Role: CONTACT

Phone: 0034 954486507

Email: [email protected]

Alberto M. Heredia Rizo, PhD

Role: CONTACT

Phone: 0034 954486507

Email: [email protected]

Facility Contacts

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Ramon Gonzalez Matilla, MSc

Role: primary

Ramon Gonzalez-Matilla, MSc

Role: backup

Alberto M Heredia-Rizo, PhD

Role: primary

Alberto M. Heredia-Rizo, PhD

Role: backup

Other Identifiers

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NEUROREHAB

Identifier Type: -

Identifier Source: org_study_id