Talocrural Mobilization With Movement in Spastic Cerebral Palsy

NCT ID: NCT06598657

Last Updated: 2025-02-21

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-10-02
• Study Completion Date: 2025-10-25

Brief Summary

The aim of this randomized controlled trial is to find the effect of Mulligan's Mobilization with Movement of Talocrural joint in Cerebral Palsy Patients having spasticity on improving Ankle Range of Motion, improving balance and its effect on Gait speed.

Detailed Description

Cerebral palsy is a neurodevelopmental disorder involving abnormalities in muscle tone and motor function due to damaged cerebral tissue in development. It is a nonprogressive upper motor neuron lesion characterized by abnormal tone, posture, balance and movement and clinically classified based on the predominant motor syndrome. In spastic CP, there is significant weakness that contributes to abnormal posture and movement. This is also accompanied by decreased muscle endurance and loss of selective motor control (SMC). Spastic diplegia is a very common form of CP, with a wide range of ambulatory outcomes, and is most frequently accompanied by ankle spasticity. Abnormalities, such as excessive plantar flexion of the ankle, leads to individuals with CP have in both static and dynamic balance.

Joint mobilization has not only the mechanical effect of disrupting the contracture by direct movement of the joint area, but also stimulates mechanoreceptor activation when stretching occurs in the capsule and ankle ligaments.

The Mulligan Mobilization with movement (MWM) is a physical therapy technique that combines joint mobilization techniques with active movement. It aims to improve joint range of motion, reduce stiffness, and enhance functional mobility, is expected to produce an instantaneous improvement in the patient's abilities by simultaneous applying of pain-free accessory glides.

This study will contribute in describing long lasting effects of Mobilization With Movement, with multiple assessments, on ankle range of motion, balance, and gait speed, and to check whether the amount of regaining is similar between patients undergoing MWM with conventional therapy and those with conventional therapy alone

Conditions

Spastic Cerebral Palsy (sCP)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Mobilization with Movement MWM of Talocrural joint + Conventional PT

Group Type: ACTIVE_COMPARATOR

Mobilization with Movement MWM

Intervention Type: OTHER

Mobilization with Movement MWM of Talocrural joint in non-weight bearing position to improve Dorsiflexion Range of Motion (3 sets of 6 repetitions were applied, with a 1-minute break between sets/3 times a week) and conventional therapy which includes stretching, strengthening, balance training exercise.

Conventional PT

Group Type: OTHER

Conventional Treatment

Intervention Type: OTHER

• Stretches of Hamstrings, Gastrocnemius, Soleus and hip adductors with duration of 20 sec hold/ 5 reps and Frequency: 3 times/week. Stretches will be performed passively
• Strengthening exercises of Quadriceps and abdominal muscles three times a week.
• Static balance exercises including single leg balance, tandem stance, weight shifting with Duration: 10 sec hold/ 5 reps Frequency: 3 times/week

Interventions

Mobilization with Movement MWM

Mobilization with Movement MWM of Talocrural joint in non-weight bearing position to improve Dorsiflexion Range of Motion (3 sets of 6 repetitions were applied, with a 1-minute break between sets/3 times a week) and conventional therapy which includes stretching, strengthening, balance training exercise.

Intervention Type: OTHER

Conventional Treatment

• Stretches of Hamstrings, Gastrocnemius, Soleus and hip adductors with duration of 20 sec hold/ 5 reps and Frequency: 3 times/week. Stretches will be performed passively
• Strengthening exercises of Quadriceps and abdominal muscles three times a week.
• Static balance exercises including single leg balance, tandem stance, weight shifting with Duration: 10 sec hold/ 5 reps Frequency: 3 times/week

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Both genders
• Age group 8-18 years
• Diagnosis of spastic Cerebral Palsy
• CP to follow verbal directions
• Modified Ashworth Scale score of '1' or '1+'
• Function classification system (GMFCS) level I or II ability to walk
• 10 m or more independently

Exclusion Criteria

• visual, hearing disorders
• verbal and cognitive disorders (unable to comprehend commands)
• recent lower extremity surgery
• botulinum toxin injection

• Minimum Eligible Age: 8 Years
• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

KINZA ANWAR, MS-OMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

PAF School for Persons With special Needs PNS, Islamabad

Islamabad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

KINZA ANWAR, MS-OMPT

Role: CONTACT

kinza.anwar@riphah.edu.pk

+92-3239735427

Facility Contacts

KINZA ANWAR, MS-OMPT

Role: primary

kinza.anwar@riphah.edu.pk

+92-3239735427

MAIMOONA MUBARIK, MS-OMPT*

Role: backup

Other Identifiers

REC/01877 Maimoona Mubarik

Identifier Type: -

Identifier Source: org_study_id