Quadriplegic Cerebral PalsyCPluxprev2020NCT04603625
Postural Management for Hip Luxation in Quadriplegic Cerebral Palsy
A study testing postural management in people with Quadriplegic Cerebral Palsy, run by Azienda USL Reggio Emilia - IRCCS at 1 site in Italy.
Trial summary
Cerebral palsy (CP) is the most common motor disability in childhood. Among these, hip luxation represents the most frequent and clinically relevant one, affecting 72% of non-ambulatory CP children. Read more about this study
- Who is it for?
- Ages 1 year to 6 years
- Conditions the study is for
- Quadriplegic Cerebral Palsy
- What is being tested?
- postural management
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 17 participants
- Where
- 1 siteItaly
- Study dates
- 29 Oct 2020to 31 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 1 year to 6 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Cerebral palsy spastic or dyskinetic
- GMFCS 4 or 5
- MP<41%
- Informed Consent acquired
Who cannot join
- muscle contracture overcoming defined passive Range Of Motion (ROM)limits
- anterior hip luxation
- previous reconstructive hip surgery
- preventive surgery in previous 12 months
- lumbar scoliosis >20° Cobb
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Postural Management to Prevent Hip Luxation in Quadriplegic Cerebral Palsy Children: Comparing Two Approaches in a Randomized Controlled Trial
Cerebral palsy (CP) is the most common motor disability in childhood. Among these, hip luxation represents the most frequent and clinically relevant one, affecting 72% of non-ambulatory CP children. Reconstructive surgical treatment is debated in severe CP children, for whom it is crucial to identify an effective preventive approach. The aim of our study is to verify if keeping a sitting position centering femoral heads is more effective than usual postural management (sitting with the trunk aligned and hips abducted), in preventing hip luxation in quadriplegic CP children. It's a multicenter randomized controlled study (13 sites involved). A total of 102 quadriplegic CP children, aged 1-6 years-old, classified as Gross Motor Function Measure System 4 or 5, will be recruited and randomized to usual or experimental sitting, at least 5 hours a day, for 2 years. The primary outcome will be the degree of luxation, measured by means of the Migration Percentage (MP), on pelvic radiography, at 12 and 24 months. Secondary outcomes will include compliance and Health Related-Quality of Life, using validated tools, hip pain, device cost, MRI lesions, concurrent direct neuromotor treatment, use of standing devices and spasticity treatments (botulinum toxin, per os or intrathecal baclofen, selective dorsal rhizotomy). Experimental sitting is expected to reduce the MP change compared to usual care. It will be of interest to compare compliance, QoL and costs in either groups: aspects affecting the effectiveness. Furthermore to evaluate correlations between MP and spasticity treatments, MRI lesion type, and other clinical features.
- Conditions
- Quadriplegic Cerebral Palsy
- Being tested
- postural management
- Keywords
- hip luxation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
postural managementOther
postural management in sitting position
| Study group | Role | What they receive |
|---|---|---|
| sitting position centering femoral heads | Experimental | sitting position centering femoral heads according to Lespargot diagram Receives: Other: postural management |
| Usual postural management | Active comparator | sitting with the trunk aligned and hips abducted to facilitate activities of daily living Receives: Other: postural management |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Migration Percentage
measure of hip luxation on pelvic radiography
Measured: Day 0, Month 12, Months 24
Secondary outcomes (14)
Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
Parents will fill in a questionnaire about Health Related Quality of Life referred to their child. Minimum value 0, maximum value 100, higher scores mean a better outcome.
Measured: Day 0, Month 12, Month 24
Quebec User Evaluation of Satisfaction with Assistive Technology (IT-QUEST)
Parents will fill in a questionnaire measuring their satisfaction about the assistive device ensuring the desired sitting position of their child. Minimum value 1, maximum value 5,higher scores mean a better outcome.
Measured: Month 12, Month 24
Incidence of pain
Care givers will be interviewed about presence or absence of hip pain in the previous months during personal care and activities of daily living
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Assistive devices costs
Costs paid by Health Institution for sitting systems used during the study
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients attending Botulinum Toxin-A injections
Botulinum Toxin-A injections in muscles around the hip during the study will be recorded
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients attending direct physical treatment
Physiotherapy, other Neuromotor Therapy during the study
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients using standing devices in abduction
It will be recorded if the patients will be using standing devices at least 5 hours/week, less than 5 h/week or never
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Type of CP (Dyskinetic or spastic)
Type of CP will be recorded to evaluate any association with MP change
Measured: Day 0
Percentage of patients having Intrathecal Baclofen (ITB)
It will be recorded if patients have ITB to evaluate any association with MP change
Measured: Day 0
Percentage of patients taking Baclofen per os
Baclofen oral medication during the study will be recorded
Measured: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients who underwent Selective Dorsal Rhizotomy (SDR)
It will be recorded if patients underwent SDR in the past to evaluate any association with MP change
Measured: Day 0
Age
Age will be recorded to evaluate any association with MP change
Measured: Day 0
Sex
Sex will be recorded to evaluate any association with MP change
Measured: Day 0
Type of lesion at MRI
Type of lesion at MRI, according to Neonatal Neuroimaging Classification System (maldevelopments | predominant white matter injury | predominant grey matter injury | miscellaneous | Normal). Data will be registered based on previously acquired MRI, considering that the exam is mandatory for the diagnosis of cerebral palsy. It will be recorded to evaluate any association with MP change
Measured: Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Oct 2020
- Study start29 Oct 2020
- Primary completion10 Dec 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for Quadriplegic Cerebral PalsyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 17 participants (actual)
Sponsor and investigators
- Lead sponsor
- Azienda USL Reggio Emilia - IRCCS
- Sponsor type
- Other government
- Collaborators
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Ospedale IRCCS G. Gaslini di Genova, IRCCS Eugenio Medea, IRCCS Don Carlo Gnocchi di Firenze, Azienda Unita' Sanitaria Locale Di Modena, Azienda Usl di Bologna, Azienda Unità Sanitaria Locale della Romagna, Azienda ULSS di Verona e Provincia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Responsible party
- Sponsor
- Investigators
- SILVIA FACCIOLI, Study chair, Azienda USL Reggio Emilia - IRCCS
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04603625
- Sponsor's protocol ID
- 723/2020/SPER/AUSLRE
- Acronym
- CPluxprev2020
- Status last verified
- May 2026
- First submitted
- 1 Oct 2020
- Last updated
- 7 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: We are going to share results and data at the end of the study by publication
Publications
Bouwhuis CB, van der Heijden-Maessen HC, Boldingh EJ, Bos CF, Lankhorst GJ. Effectiveness of preventive and corrective surgical intervention on hip disorders in severe cerebral palsy: a systematic review. Disabil Rehabil. 2015;37(2):97-105. doi: 10.3109/09638288.2014.908961. Epub 2014 Apr 14.
PubMed 24731007Dalen Y, Saaf M, Ringertz H, Klefbeck B, Mattsson E, Haglund-Akerlind Y. Effects of standing on bone density and hip dislocation in children with severe cerebral palsy. Adv Physiother,2010;12:187-93.
Diab M, Staheli LT. Ortopedia Pediatrica, 3° ed., Verduci ed., p.65
Galeoto G, Colucci M, Guarino D, Esposito G, Cosma E, De Santis R, Grifoni G, Valente D, Tofani M. Exploring Validity, Reliability, and Factor Analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology in an Italian Population: A Cross-Sectional Study. Occup Ther Health Care. 2018 Oct;32(4):380-392. doi: 10.1080/07380577.2018.1522682. Epub 2018 Dec 31.
PubMed 30596451Hagglund G, Goldring M, Hermanson M, Rodby-Bousquet E. Pelvic obliquity and measurement of hip displacement in children with cerebral palsy. Acta Orthop. 2018 Dec;89(6):652-655. doi: 10.1080/17453674.2018.1519104. Epub 2018 Oct 17.
PubMed 30326758Hagglund G, Lauge-Pedersen H, Wagner P. Characteristics of children with hip displacement in cerebral palsy. BMC Musculoskelet Disord. 2007 Oct 26;8:101. doi: 10.1186/1471-2474-8-101.
PubMed 17963501• Lespargot A. La luxation postéro-externe de la hanche chez l'enfant IMC ou polyhandicapé. Motricité cérébrale,1991;12:37-61
Lins LAB, Watkins CJ, Shore BJ. Natural History of Spastic Hip Disease. J Pediatr Orthop. 2019 Jul;39(Issue 6, Supplement 1 Suppl 1):S33-S37. doi: 10.1097/BPO.0000000000001347.
PubMed 31169645Martinsson C, Himmelmann K. Effect of weight-bearing in abduction and extension on hip stability in children with cerebral palsy. Pediatr Phys Ther. 2011 Summer;23(2):150-7. doi: 10.1097/PEP.0b013e318218efc3.
PubMed 21552077Gmelig Meyling C, Ketelaar M, Kuijper MA, Voorman J, Buizer AI. Effects of Postural Management on Hip Migration in Children With Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2018 Apr;30(2):82-91. doi: 10.1097/PEP.0000000000000488.
PubMed 29578990Miller SD, Juricic M, Hesketh K, Mclean L, Magnuson S, Gasior S, Schaeffer E, O'donnell M, Mulpuri K. Prevention of hip displacement in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2017 Nov;59(11):1130-1138. doi: 10.1111/dmcn.13480. Epub 2017 Jun 2.
PubMed 28574172Narayanan UG, Fehlings D, Weir S, Knights S, Kiran S, Campbell K. Initial development and validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Dev Med Child Neurol. 2006 Oct;48(10):804-12. doi: 10.1017/S0012162206001745.
PubMed 16978459Picciolini O, LE Metayer M, Consonni D, Cozzaglio M, Porro M, Gasparroni V, Panou A, Mosca F, Portinaro NM. Can we prevent hip dislocation in children with cerebral palsy? Effects of postural management. Eur J Phys Rehabil Med. 2016 Oct;52(5):682-690. Epub 2016 May 6.
PubMed 27153480Sproccati N, Bertana S, Battisti N, Feliciangeli A, Baroncini C, Zenesini C, Cersosimo A. Italian translation and cross-cultural adaptation of the questionnaire for the assessment of quality of life in children with cerebral palsy: Caregiver priorities and Child Health Index of Life with disabilities. Minerva Med. 2021 Oct;112(5):651-653. doi: 10.23736/S0026-4806.19.06072-5. Epub 2019 Jun 25. No abstract available.
PubMed 31256575Terjesen T. The natural history of hip development in cerebral palsy. Dev Med Child Neurol. 2012 Oct;54(10):951-7. doi: 10.1111/j.1469-8749.2012.04385.x. Epub 2012 Aug 13.
PubMed 22881288
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Postural Management to Prevent Hip Luxation in Quadriplegic Cerebral Palsy Children: Comparing Two Approaches in a Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT04603625
- Acronym / sponsor ID
- CPluxprev2020 / 723/2020/SPER/AUSLRE
- Conditions
- Quadriplegic Cerebral Palsy
- Keywords
- hip luxation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 17 participants (actual)
- Lead sponsor
- Azienda USL Reggio Emilia - IRCCSOther government
- Collaborators
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Ospedale IRCCS G. Gaslini di Genova, IRCCS Eugenio Medea, IRCCS Don Carlo Gnocchi di Firenze, Azienda Unita' Sanitaria Locale Di Modena, Azienda Usl di Bologna, Azienda Unità Sanitaria Locale della Romagna, Azienda ULSS di Verona e Provincia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Study start
- 29 Oct 2020 (actual)
- Primary completion
- 10 Dec 2025 (actual)
- Study completion
- 31 Dec 2025 (actual)
- First posted
- 27 Oct 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Cerebral palsy (CP) is the most common motor disability in childhood. Among these, hip luxation represents the most frequent and clinically relevant one, affecting 72% of non-ambulatory CP children. Reconstructive surgical treatment is debated in severe CP children, for whom it is crucial to identify an effective preventive approach. The aim of our study is to verify if keeping a sitting position centering femoral heads is more effective than usual postural management (sitting with the trunk aligned and hips abducted), in preventing hip luxation in quadriplegic CP children. It's a multicenter randomized controlled study (13 sites involved). A total of 102 quadriplegic CP children, aged 1-6 years-old, classified as Gross Motor Function Measure System 4 or 5, will be recruited and randomized to usual or experimental sitting, at least 5 hours a day, for 2 years. The primary outcome will be the degree of luxation, measured by means of the Migration Percentage (MP), on pelvic radiography, at 12 and 24 months. Secondary outcomes will include compliance and Health Related-Quality of Life, using validated tools, hip pain, device cost, MRI lesions, concurrent direct neuromotor treatment, use of standing devices and spasticity treatments (botulinum toxin, per os or intrathecal baclofen, selective dorsal rhizotomy). Experimental sitting is expected to reduce the MP change compared to usual care. It will be of interest to compare compliance, QoL and costs in either groups: aspects affecting the effectiveness. Furthermore to evaluate correlations between MP and spasticity treatments, MRI lesion type, and other clinical features.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| sitting position centering femoral heads | Experimental | Other: postural managementsitting position centering femoral heads according to Lespargot diagram |
| Usual postural management | Active comparator | Other: postural managementsitting with the trunk aligned and hips abducted to facilitate activities of daily living |
Who may qualify
- Ages
- 1 year to 6 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Cerebral palsy spastic or dyskinetic
- GMFCS 4 or 5
- MP<41%
- Informed Consent acquired
Key exclusion criteria (5 listed)
- muscle contracture overcoming defined passive Range Of Motion (ROM)limits
- anterior hip luxation
- previous reconstructive hip surgery
- preventive surgery in previous 12 months
- lumbar scoliosis >20° Cobb
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| postural managementpostural management in sitting position | Other | Usual postural management, sitting position centering femoral heads |
Primary outcome
Change in Migration Percentage
Time frame: Day 0, Month 12, Months 24
measure of hip luxation on pelvic radiography
14 secondary outcomes
Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
Time frame: Day 0, Month 12, Month 24
Quebec User Evaluation of Satisfaction with Assistive Technology (IT-QUEST)
Time frame: Month 12, Month 24
Incidence of pain
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Assistive devices costs
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients attending Botulinum Toxin-A injections
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients attending direct physical treatment
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients using standing devices in abduction
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Type of CP (Dyskinetic or spastic)
Time frame: Day 0
Percentage of patients having Intrathecal Baclofen (ITB)
Time frame: Day 0
Percentage of patients taking Baclofen per os
Time frame: Day 0, Month 6, Month 12, Month 18, Month 24
Percentage of patients who underwent Selective Dorsal Rhizotomy (SDR)
Time frame: Day 0
Age
Time frame: Day 0
Sex
Time frame: Day 0
Type of lesion at MRI
Time frame: Day 0
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2026.
- Background: PubMed 24731007Bouwhuis CB, van der Heijden-Maessen HC, Boldingh EJ, Bos CF, Lankhorst GJ. Effectiveness of preventive and corrective surgical intervention on hip disorders in severe cerebral palsy: a systematic review. Disabil Rehabil. 2015;37(2):97-105. doi: 10.3109/09638288.2014.908961. Epub 2014 Apr 14.
- BackgroundDalen Y, Saaf M, Ringertz H, Klefbeck B, Mattsson E, Haglund-Akerlind Y. Effects of standing on bone density and hip dislocation in children with severe cerebral palsy. Adv Physiother,2010;12:187-93.
- BackgroundDiab M, Staheli LT. Ortopedia Pediatrica, 3° ed., Verduci ed., p.65
- Background: PubMed 30596451Galeoto G, Colucci M, Guarino D, Esposito G, Cosma E, De Santis R, Grifoni G, Valente D, Tofani M. Exploring Validity, Reliability, and Factor Analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology in an Italian Population: A Cross-Sectional Study. Occup Ther Health Care. 2018 Oct;32(4):380-392. doi: 10.1080/07380577.2018.1522682. Epub 2018 Dec 31.
- Background: PubMed 30326758Hagglund G, Goldring M, Hermanson M, Rodby-Bousquet E. Pelvic obliquity and measurement of hip displacement in children with cerebral palsy. Acta Orthop. 2018 Dec;89(6):652-655. doi: 10.1080/17453674.2018.1519104. Epub 2018 Oct 17.
- Background: PubMed 17963501Hagglund G, Lauge-Pedersen H, Wagner P. Characteristics of children with hip displacement in cerebral palsy. BMC Musculoskelet Disord. 2007 Oct 26;8:101. doi: 10.1186/1471-2474-8-101.
- Background• Lespargot A. La luxation postéro-externe de la hanche chez l'enfant IMC ou polyhandicapé. Motricité cérébrale,1991;12:37-61
- Background: PubMed 31169645Lins LAB, Watkins CJ, Shore BJ. Natural History of Spastic Hip Disease. J Pediatr Orthop. 2019 Jul;39(Issue 6, Supplement 1 Suppl 1):S33-S37. doi: 10.1097/BPO.0000000000001347.
- Background: PubMed 21552077Martinsson C, Himmelmann K. Effect of weight-bearing in abduction and extension on hip stability in children with cerebral palsy. Pediatr Phys Ther. 2011 Summer;23(2):150-7. doi: 10.1097/PEP.0b013e318218efc3.
- Background: PubMed 29578990Gmelig Meyling C, Ketelaar M, Kuijper MA, Voorman J, Buizer AI. Effects of Postural Management on Hip Migration in Children With Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2018 Apr;30(2):82-91. doi: 10.1097/PEP.0000000000000488.
- Background: PubMed 28574172Miller SD, Juricic M, Hesketh K, Mclean L, Magnuson S, Gasior S, Schaeffer E, O'donnell M, Mulpuri K. Prevention of hip displacement in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2017 Nov;59(11):1130-1138. doi: 10.1111/dmcn.13480. Epub 2017 Jun 2.
- Background: PubMed 16978459Narayanan UG, Fehlings D, Weir S, Knights S, Kiran S, Campbell K. Initial development and validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Dev Med Child Neurol. 2006 Oct;48(10):804-12. doi: 10.1017/S0012162206001745.
- Individual participant dataSharing planned: No. We are going to share results and data at the end of the study by publication
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
SILVIA FACCIOLI study chair
Azienda USL Reggio Emilia - IRCCS
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing postural management in people with Quadriplegic Cerebral Palsy, run by Azienda USL Reggio Emilia - IRCCS at 1 site in Italy.
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 5 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: finished, as of the sponsor's last update on 7 May 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 Italy. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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 Migration Percentage (time frame: Day 0, Month 12, Months 24). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04603625, which also lists 17 linked publications.
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 7 May 2026.