Investigating the Effectiveness of Graded Motor Imagery Training in Children With Obstetric Brachial Plexus Injury

NCT ID: NCT06966544

Last Updated: 2025-05-12

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-04
• Study Completion Date: 2025-07-20

Brief Summary

The aim of this study is to investigate the effect of graded motor imagery training on upper extremity motor function, proprioception, functional mobility, balance and quality of life in patients with obstetric brachial plexus injury in addition to conventional treatment. In this context, our aim is to identify new and potential physiotherapeutic approaches to address deficits in motor planning that have been shown to occur at the level of the central nervous system.

Detailed Description

This study was planned as a randomized, controlled, single-blind study. The aim of this study was to investigate the effects of graded motor imagery (GMI) training, performed in addition to conventional treatment of patients with obstetric brachial plexus injury, on upper extremity motor function, proprioception, functional mobility and quality of life. In parallel to the initial assessment, a conventional physiotherapy program was created that is individualized according to the functional status and severity of the effects in the children. In the GMI program, in addition to this program, the components of GMI training are applied to sequentially activate the cortical motor networks and develop cortical organization. All assessments of the participants before and at the end of the treatment are carried out by a blind physiotherapist.

Conditions

Obstetric Brachial Plexus Injury

Study Design

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

Study Groups

Conventional Physiotherapy Group

Participants were randomly divided into two arms. Participants in the activate comparator group will be administered traditional physiotherapy approaches applied after obstetric brachial plexus injury by the researcher physiotherapist.

Group Type: ACTIVE_COMPARATOR

Conventional Physiotherapy

Intervention Type: OTHER

All subjects to be included in our study were evaluated before and after treatment by a physiotherapist acting as a blinded evaluator. In the treatment, conventional physiotherapy approaches are applied twice a week for 8 weeks by the physiotherapist conducting the thesis study. In parallel with the initial evaluation, an individualized conventional physiotherapy program is created according to the functional status of the children and the severity and type of the affected area.

The main topics of this program consist of the following: Normal range of motion exercises for shoulder, elbow, wrist and fingers, strengthening exercises for scapulothoracic, shoulder, elbow, hand-wrist joints in all directions, stretching exercises for shoulder, elbow, wrist, fingers (to be selected depending on the patient's involvement), scapulothoracic mobilization, glenohumeral mobilization and elbow according to possible limitations, hand-wrist joint mobilization techniques (myofascial release, gliding

Graded Motor Imagery Group

Participants included in the motor imagery group through randomization will receive a progressive motor imagery approach in addition to the conventional physiotherapy treatment received by the first group. All applications are performed by the same physiotherapist.

Group Type: EXPERIMENTAL

Graded Motor Imagery

Intervention Type: OTHER

All approaches applied to the conventional physiotherapy group are applied to this group in the same manner and duration (8 weeks-twice a week). However, in addition to conventional physiotherapy, progressive motor imagery (AMI) training program is being applied twice a week for 8 weeks.

In the GMI program, in addition to this program, components of GMI training will be applied to sequentially activate cortical motor networks and improve cortical organization. These are;

• Laterality training with the help of visuals selected in the first stage (0-2 weeks)
• In the second stage, motor imagery activities designed in the form of scenarios to be developed specifically for motor activity deficiencies seen in OBPY (2-5 weeks)
• In the third stage, a mirror therapy program will be prepared (5-8 weeks).

Interventions

Conventional Physiotherapy

All subjects to be included in our study were evaluated before and after treatment by a physiotherapist acting as a blinded evaluator. In the treatment, conventional physiotherapy approaches are applied twice a week for 8 weeks by the physiotherapist conducting the thesis study. In parallel with the initial evaluation, an individualized conventional physiotherapy program is created according to the functional status of the children and the severity and type of the affected area.

The main topics of this program consist of the following: Normal range of motion exercises for shoulder, elbow, wrist and fingers, strengthening exercises for scapulothoracic, shoulder, elbow, hand-wrist joints in all directions, stretching exercises for shoulder, elbow, wrist, fingers (to be selected depending on the patient's involvement), scapulothoracic mobilization, glenohumeral mobilization and elbow according to possible limitations, hand-wrist joint mobilization techniques (myofascial release, gliding

Intervention Type: OTHER

Graded Motor Imagery

All approaches applied to the conventional physiotherapy group are applied to this group in the same manner and duration (8 weeks-twice a week). However, in addition to conventional physiotherapy, progressive motor imagery (AMI) training program is being applied twice a week for 8 weeks.

In the GMI program, in addition to this program, components of GMI training will be applied to sequentially activate cortical motor networks and improve cortical organization. These are;

• Laterality training with the help of visuals selected in the first stage (0-2 weeks)
• In the second stage, motor imagery activities designed in the form of scenarios to be developed specifically for motor activity deficiencies seen in OBPY (2-5 weeks)
• In the third stage, a mirror therapy program will be prepared (5-8 weeks).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Obtaining family consent and the child's willingness
• Being between the ages of 7-18
• Being diagnosed with obstetric brachial plexus injury
• Not having received physical therapy in the last 6 months

Exclusion Criteria

• Having a traumatic (postnatal) brachial plexus injury
• Having undergone surgery for complications related to brachial plexus injury within the last six months (release, tendon transfer, osteotomy, etc.)
• Having another neurological, neuromuscular, musculoskeletal or cardiopulmonary system disease in addition to OBPI

• Minimum Eligible Age: 7 Years
• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Izmir Bakircay University

OTHER

Sponsor Role: lead

Responsible Party

Hüseyin MAHİROĞLU

PhD Student

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Gulbin Ergin, Associate Professor

Role: STUDY_DIRECTOR

İzmir Bakırcay University

Locations

Izmir Bakircay University Physiotherapy and Rehabilitation Application and Research Center

Izmir, Menemen, Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

Hüseyin MAHİROĞLU, Msc

Role: CONTACT

huseyin.mahiroglu@tinaztepe.edu.tr

+905327011772

Facility Contacts

Hüseyin MAHİROĞLU, MSc.

Role: primary

huseyin.mahiroglu@tinaztepe.edu.tr

+905327011772

Role: backup

huseyin.mahiroglu@tinaztepe.edu.tr

Other Identifiers

BakircayU-FTR-HM-01

Identifier Type: -

Identifier Source: org_study_id