The Socioeconomic Status and Child Characteristics on the Physical Therapy Outcome in Children With Spastic Cerebral Palsy
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|ClinicalTrials.gov Identifier: NCT04160403|
Recruitment Status : Completed
First Posted : November 13, 2019
Last Update Posted : January 18, 2020
|Condition or disease||Intervention/treatment||Phase|
|C10.228.140.140.254||Other: physical therapy intervention||Not Applicable|
This study had four stages, the first one make registry from a computer database of outpatient clinic faculty of physical therapy Cairo university for all children with cerebral palsy under four years old age. In the second stage the files of 100 children registered were studied to select spastic cerebral palsy without the following; associated disorders, congenital anomalies, perceptual disorders, IQ below 80%, or another diagnosis ( nerve lesion, genetic disorders). Before the evaluation stage, every parent of each selected child was aware with the purpose of the study and signed the written informed consent that was approved by the ethical committee faculty of Physical Therapy Cairo University.Evaluation
The 83 selected children were evaluated as follow:
- Muscle tone assessment Modified Ashworth scale is a valid and reliable test for measure muscle tone (Mutlu, 2008) table 1. Then evaluate the tone distribution throughout the body to determine its type diplegia, quadriplegia, or hemiplegia.
- Severity The gross motor function classification system (GMFCS) is a reliable and valid system to classify the children with CP according to their age- specific motor activity (Palisano, 2000). GMFCS is a time-independent variable and it has five levels of severity (I, II, III, IV &V). The children with level I& II grouped as mild cases, children with level III were moderate cases, and those with IV & V levels were sever cases.
- The gross motor function measure The Gross motor function measure (GMFM-88) is a valid clinical assessment tool designed to evaluate gross motor function, and its change over time in children with cerebral palsy (Russell, 2013). (GMFM-88) consists of 88 items in five dimensions A: Lying and Rolling (17 items), B: Sitting (20 items), C: Crawling and Kneeling (14 items), D: Standing (13 items), and E: Walking, Running and Jumping( 24 items). Each item was scored as 0 - does not initiate, 1 - initiates, 2 - partially completes, and 3 - completed, or not tested. The GMFM total scores are a summation of the scores for all dimensions and dividing by 5. A percentage score was calculated for the total score so it ranges from 0 to 100.
- Socioeconomic status (SES) SES was evaluated by a valid and updated of the socioeconomic status scale for health research in Egypt scale (El-Gilany, 2012). It includes 7 domains with a total score of 84 ; 1- education and cultural domain(for both husband & wife) (score = 30); 2- family domain (score = 10); 3- occupation domain(for both husband & wife) (score = 10); 4- Family possessions domain (score = 12); 5- home sanitation domain (score = 12); 6- health care domain (score = 5); 7- economic domain(score = 5). According to the quartiles of the score calculated, the socioeconomic level is classified into very low, low, middle and high levels.
Physical therapy program The trained physiotherapists did the physical therapy interventions based on neurodevelopmental technique (NDT) and strength training for all participated children in the study for three times per week along sex months. During the study, the parents were asked to be adhering to the sessions Follow up After 6 months of the physical therapy program, the GMFM88 for 80 children were evaluated again to determine the progress of motor functions.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||80 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||prospective cohort study|
|Masking:||None (Open Label)|
|Masking Description:||the data about socioeconomic status did not be announced|
|Official Title:||The Factors as Socioeconomic Status and Child Characteristics That May Impact on the Progress of Development After Physical Therapy Interventions in Children With Spastic Cerebral Palsy|
|Actual Study Start Date :||January 6, 2019|
|Actual Primary Completion Date :||July 23, 2019|
|Actual Study Completion Date :||December 26, 2019|
Experimental: factors ( SES,age, sex,severity) and progress
the relation between progress in gross motor functions
Other: physical therapy intervention
NDT bases on neuroplasticity by which the brain change and reorganize itself and its processes according to practice and experience by a) facilitation of normal postural alignment and movement patterns; b) inhibition of the involvement during developmental and functional activities; and c) using sensory feedback (manual contact, visual integration, somatosensory reinforcement) for recovering function
- gross motor function measure [ Time Frame: 20 minutes ]The Gross motor function measure (GMFM-88) is a valid clinical assessment tool designed to evaluate gross motor function, and its change over time in children with cerebral palsy (Russell, 2013). (GMFM-88) consists of 88 items in five dimensions A: Lying and Rolling (17 items), B: Sitting (20 items), C: Crawling and Kneeling (14 items), D: Standing (13 items), and E: Walking, Running and Jumping( 24 items). Each item was scored as 0 - does not initiate, 1 - initiates, 2 - partially completes, and 3 - completed, or not tested. The GMFM total scores is summation of the scores for all dimensions and dividing by 5. A percentage score was calculated for total score so it ranges from 0 to 100.
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Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04160403
|Cairo, Dokki, Egypt, 11432|
|Principal Investigator:||zeinab hussein||pediatric physical therapy|