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Cerebral PalsyNCT04360395

Igniting Mobility in Adolescents and Young Adults With Cerebral Palsy

A study testing Gait Therapy in people with Cerebral Palsy, run by Father Flanagan's Boys' Home at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The study design will consist of a cohort of adolescents and young adults with cerebral palsy (CP) that will undergo a gait training protocol. All participants will complete MEG or EEG baseline brain imaging measures of their sensorimotor cortical activity, MRI brain/spinal cord imaging (previous MRI or template brain… Read more about this study

Who is it for?
Ages 13 to 18 yearsHealthy volunteers can take part
Conditions the study is for
Cerebral Palsy
What is being tested?
Gait Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteUnited States
Study dates
3 Aug 2020to 31 May 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 13 to 18 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • For Cerebral Palsy participants:
  • Cerebral Palsy diagnosis
  • For Non-Cerebral Palsy Controls:
  • No known atypical neurodevelopment (e.g autism, Down Syndrome, ADHD, etc.)

Who cannot join

  • No orthopedic surgery in the last 6 months or metal in their body that would preclude the use of an MRI.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Boys Town National Research Hospital

    Boys Town, Nebraska, 68010

Other trials in United States

About this study

The study design will consist of a cohort of adolescents and young adults with cerebral palsy (CP) that will undergo a gait training protocol. All participants will complete MEG or EEG baseline brain imaging measures of their sensorimotor cortical activity, MRI brain/spinal cord imaging (previous MRI or template brain may be substituted), neurophysiological tests of the spinal cord H-reflex, and a series of mobility clinical tests and cognitive tests. Participants with metal in their body that would interfere with the MEG (e.g., braces on teeth, permanent retainer) will not undergo the MEG tests but will undergo the EEG assessments. Those who complete the MEG assessments will not undergo the EEG assessments.

After completing the baseline tests, the participants with CP will undergo the therapeutic gait training. After completing all of the therapeutic gait training sessions, the participants with CP will repeat the same assessments that were completed at baseline.

Separately, a cohort of neurotypical adolescents and young adults will also complete the baseline assessments. The neurotypical participants will not undergo the therapeutic gait training, but will be used as a normative group for interpreting if the changes seen in the participants with CP after therapy are in fact moving the system toward a normative state.

Read the detailed description

Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly pediatric neurologic conditions in the United States that often results in mobility deficits. The investigator's extensive experimental work has been focused on developing a therapeutic gait training protocol that will improve the long-term mobility of adolescents and young adults with CP. Despite the major breakthroughs, it is apparent across the investigations that some patients have vast improvements in their mobility after treatment, while others are clearly non-responders. This response variability represents one of the major Gordian knots in the treatment outcomes seen in adolescents and young adults with CP. The investigator will address this knowledge gap with a multimodal approach that blends the investigator's expertise in MEG/EEG brain imaging, MRI spinal cord imaging, and assessments of the spinal cord interneuronal circuitry to probe the neurophysiological differences in participants that are classified as responders and non-responders after therapeutic gait training. The Specific Aims of this study will: (1) identify if responders and non-responders have differences in the strength of the sensorimotor cortical oscillations involved in the planning and execution of a leg motor action, (2) determine if responders and non-responders have differences in the neural synchrony within the somatosensory cortices, following stimulation of the foot mechanoreceptors, and (3) decipher if responders and non-responders have differences in the spinal cord microstructure and circuitry dynamics. (4) Secondary aim: assess cognitive related changes induced via physical therapy. Briefly, the study design consists of a cohort of adolescents and young adults with CP that will initially undergo MEG/EEG brain imaging, MRI spinal cord imaging, neurophysiological tests of the spinal cord interneuronal circuitry, cognitive testing, and clinical mobility assessments. After completing the baseline tests, the participants will undergo the therapeutic gait training protocol. Upon completion of the treatment program, the participants will repeat the same assessments that were completed at baseline. Separation of the participants into responders and non-responders to treatment will be based on the criteria for a clinically relevant change in the 10-meter walking speed test. The new data derived from this project will provide unparalleled insight on the potential neurophysiological origins of the diverse mobility outcomes seen in adolescents and young adults with CP after treatment. Finally, an additional cohort of neurotypical adolescents and young adults of similar age and sex will also complete the mobility, MEG/EEG, spinal cord imaging, and Hoffmann reflex protocols for comparative purposes.

Conditions
Cerebral Palsy
Being tested
Gait Therapy
Keywords
Cerebral Palsy, Gait therapy, Mobility
Medical subject headings
Cerebral Palsy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Gait TherapyBehavioural

    The therapeutic gait training protocol will consist of 24-treatment sessions that will be performed 3 times-a-week for an 8-week period. All therapeutic exercises will be performed under the direction of a licensed pediatric physical therapist. Any sessions missed will be added on to the 8-week period. Each intervention session will consist of over-ground gait activities that will be completed in a 60 minute session with rests as needed. The key ingredients of the therapy will include: 1) activities of adequate intensity that promote gait adaptation and gait speed sustainment, 2) exploratory activities that enhance the somatosensory experience through rich/novel movement, and 3) optimally challenging activities that emphasize planning and problem solving that requires altering the leg kinematics to meet the environmental and task constraints.

Study groups in NCT04360395
Study groupRoleWhat they receive
Neurotypical Youth/Young AdultsNo interventionNo intervention administered. The controls will only undergo initial baseline assessments.
Cerebral Palsy Youth/Young AdultsExperimentalBaseline and 8 week assessments; 8 week gait therapy
Receives: Behavioral: Gait Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Mobility Test Time

    The participant will be asked to perform a series of timed (in seconds) 10-meter walking tasks.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  2. Change in Time for Community Ambulation

    The participants will walk along a 400 meter course laid out on the Boys Town campus that incorporates uphill/downhill grades, stairs, curbs, grass and uneven surfaces. The time (in seconds) to complete the course will be used as an outcome variable.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  3. Change in Time for "Timed Up and Go"

    The participant will start the test by sitting on a bench. The time (in seconds) it takes the participant to stand-up, walk to a line on the floor that is 3-meters away and return back to sitting on the bench will be the outcome measure.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  4. Change in Selective Control Assessment of the Lower Extremity

    This is a clinical assessment where the participant is asked to isolate and move the lower extremity joints. The examiner grades the amount of movement and the ability of the participant to isolate the control. A grade of 0 indicates the participant cannot move the joint, 1 indicates the participant can move the joint but it is impaired, and 2 indicates normal movement of the joint.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  5. Change in Level of Spasticity

    Modified Ashworth: This is a clinical assessment where the therapist passively moves the participant's joints and rates the level of spasticity. Scores range from 0-5, where 0 indicates no tone, 5 indicates rigidity.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  6. Change in Isolation of Movement

    This is a clinical assessment where the participant is asked to isolate and move the lower extremity joints. The examiner grades the amount of movement and the ability of the participant to isolate the control. A grade of 0 indicates the participant cannot move the joint, 1 indicates the participant can move the joint but it is impaired, and 2 indicates normal movement of the joint.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  7. Change in Brain Activity in Sensory Cortices

    Magnetoencephalogram (MEG) or electroencephalogram (EEG) scan: The frequency bands of interest include theta (4-8 Hz), alpha (8-12 Hz), beta(15-30 Hz) and gamma (>30 Hz).

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  8. Change in Motor Response

    Percutaneous electrical stimulations of the femoral nerve applied via an anode that is positioned on the patella and a cathode that is positioned on the popliteal fossa will be applied to the right leg. A wireless surface EMG sensor positioned on the soleus will measure the motor response. The muscular (M-wave) will be assessed while resting and walking.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  9. Change in Hoffmann Reflex

    Percutaneous electrical stimulations of the femoral nerve applied via an anode that is positioned on the patella and a cathode that is positioned on the popliteal fossa will be applied to the right leg. A wireless surface EMG sensor positioned on the soleus will measure the Hoffmann reflex. The spinal reflexes (H-wave) will be assessed while resting and walking.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

Secondary outcomes (11)
  1. Cognitive related changes induced via physical therapy -Wide Range Assessment of Memory and Learning (WRAML)

    Subtests: Finger Windows, Picture Memory, Symbolic Working Memory:

    A standardized test that measures memory functioning, evaluating both immediate and delayed memory ability in addition to the acquisition of new learning. Viable for young children and adults.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  2. Cognitive related changes induced via physical therapy - D2 - Test of Attention

    A neuropsychological measure of selective and sustained attention in addition to visual scanning speed. Participants are tasked with crossing out any letter "d" with two marks around above it or below it in any order, in a mix of other letters and with various numbers of marks around them. Viable for young children and adults.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  3. Cognitive related changes induced via physical therapy - Trail Making A+B

    A neuropsychological test of visual attention and task switching. The subject is tasked to connect a set of numbered 25 dots as quickly as possible while still maintaining accuracy, with the second test increasing in cognitive load by introducing letters as well. Viable for young children and adults.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  4. Cognitive related changes induced via physical therapy - WAIS-IV Digit Span - Youth + Adult

    A subtest of the Wechsler Memory Scales (WMS), subjects are read a sequence of numbers and asked to repeat the same sequence back to the examiner in order (forward span) or in reverse order (backward span) to measure short term memory capacity in young children and adults.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  5. Cognitive related changes induced via physical therapy - Stroop Test - Youth + Adult

    A neuropsychological test that assesses the ability to inhibit cognitive interference during the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute (the Stroop Effect). The Stroop Effect is the delay in reaction time between congruent and incongruent stimuli, Such that a mismatch between the name of a color (e.g., "blue", "green", or "red") and the color it is printed on (i.e., the word "red" printed in blue ink instead of red ink).

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  6. Cognitive related changes induced via physical therapy - Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) Questionnaire

    Children with severe developmental disabilities are often dependent on parents/caregivers for much of their daily needs. These children often have multiple co-morbid conditions which can have a significant impact on their overall health and quality of life. Interventions are aimed at preserving or improving their health, comfort and quality of life and to facilitate caregiving. CP CHILD is an instrument that aims to measure these phenomena. Respondents rate a number of areas including the difficulty of activities for their child (Scale ranging from 0-Not Possible to 6-No problem at all) and choose the level of assistance needed to perform these activities (Scale ranging from 0-Total to 3-Independent), how often their child experience pain or discomfort (Scale ranging from 0-Every day to 5-None of the time) and intensity (0-Severe to 3-None), importance of items in child's quality of life (0-Least Important to 5-Most Important), and overall health of child (0-Very Poor to 5-Excellent).

    Measured: Baseline (CP) and 8 weeks (CP)

  7. Cognitive related changes induced via physical therapy - Silver Linings Questionnaire - Adapted for CP

    A survey measure that examines the extent to which people believe their illness - in this case the questionnaire has been adapted to individuals with CP, has had a positive benefit despite the negative consequences of having CP. Participants indicate the extent to which they agree or disagree with each statement by circling a number between 5 "strongly agree" and 1 "strongly disagree"

    Measured: Baseline (CP) and 8 weeks (CP)

  8. Cognitive related changes induced via physical therapy - Child and Adolescent Sleep Checklist (CASC)

    Tool designed to identify sleep habits and to make a screening of sleep problems among preschoolers, elementary school children, and high school students.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  9. Cognitive related changes induced via physical therapy - PEDS QL Fatigue Questionnaire (Acute)

    The PedsQL Multidimensional Fatigue Scale is a symptom-specific instrument to measure fatigue across pediatric populations. It measures cognitive fatigue which focuses on problems with memory and attention, areas known to be affected in children with CP, on a scale ranging from 0-if it is never a problem and 4-if it is almost always a problem.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  10. Cognitive related changes induced via physical therapy - Pittsburgh Sleep Quality Index (PSQI)

    An effective instrument used to measure the quality and patterns of sleep in adults.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

  11. Cognitive related changes induced via physical therapy - MacArthur Scale of Subjective Social Status Youth + Adult

    Adult Version: This tool for adults, uses a pictorial representation of a symbolic ladder, developed to capture the common sense of social status based on usual socioeconomic status indicators. It has the additional advantage to allow comparisons between studies conducted in different populations.

    Youth Version: This tool is a two-item instrument that measures a how a young person perceives their family's and their own social standing

    The symbolic ladder has 10 rungs. The higher the rung, the higher the perceived social status.

    Measured: Baseline (CP and Neurotypical) and 8 weeks (CP)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Apr 2020
  2. Study start3 Aug 2020
  3. Primary completion31 May 2027 (estimated)
  4. Study completion31 May 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Parallel groups
Model description
Cerebral Palsy participants will undergo baseline mobility/brain imaging/cognitive testing, receive gait therapy, and then repeat mobility/brain imaging testing. Non-Cerebral Palsy controls will undergo the same baseline testing once as a reference group to determine a normative state for mobility. No gait therapy will be conducted.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04360395
Sponsor's protocol ID
20-24-XP
Status last verified
Jul 2026
First submitted
16 Apr 2020
Last updated
30 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The PI and all of the investigators have made a commitment to publish, in a timely manner, all of the relevant scientific information that they will derive during this project. Deidentified data will be made available upon reasonable request to the Principal Investigator (Dr. Kurz).

Questions about this trial

What is this clinical trial studying?

A study testing Gait Therapy in people with Cerebral Palsy, run by Father Flanagan's Boys' Home at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 30 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Mobility Test Time (time frame: Baseline (CP and Neurotypical) and 8 weeks (CP)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jul 2026.

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