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Cerebral PalsyNCT04911309

Functional Exercise Training With Adolescents With Cerebral Palsy

A study testing functional exercise training and standard therapy / treatment in people with Cerebral Palsy, run by University Children's Hospital Basel at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This cross-over study analyzes a novel and inclusive approach in how therapy for adolescents with CP is administered, with the main goal of examining the effects of a functional exercise intervention on motor capability and motor capacity. Read more about this study

Who is it for?
Ages 12 to 18 years
Conditions the study is for
Cerebral Palsy
What is being tested?
functional exercise training and standard therapy / treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteSwitzerland
Study dates
25 Mar 2021to 30 Oct 2022
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 12 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Diagnosis of CP.
  • Adolescents between 12 and 18 years of age.
  • Gross Motor Functional Classification System (GMFCS): I-III.
  • Cognitive abilities must include: Ability to actively engage in a training session of 60 min. duration; Ability to verbally or non-verbally communicate pain or discomfort; Ability to attend training, testing and follow-up sessions. All included participants are capable of making decisions on their own and no not show any signs of mental or cognitive limitations.

Who cannot join

  • Any surgery or botulinum toxin treatment within 6 months prior to the start of the study or surgery/serial casting / botulinum toxin injection scheduled during the study period. Other medications can be continued as prescribed by the participants' physician.
  • Known cardiovascular or pulmonary diseases that have not received medical clearance to participate in the physical exercise intervention.
  • Uncontrolled seizures or epilepsy

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • University Children's Hospital Basel

    Basel, 4056

Other trials in Switzerland

About this study

Official title: Functional Exercise Intervention With Adolescents With Cerebral Palsy

This cross-over study analyzes a novel and inclusive approach in how therapy for adolescents with CP is administered, with the main goal of examining the effects of a functional exercise intervention on motor capability and motor capacity.

It is to investigate the effects of a functional movement-based exercise intervention in a group setting on motor capacity, motor capability and quality of life in adolescents with CP compared to standard therapy.

Read the detailed description

Cerebral palsy (CP) is a permanent disorder which affects the development of movement and posture. It causes activity limitation and is oftentimes accompanied by secondary musculoskeletal problems, disturbances of sensation, perception, cognition, communication and behavior.

In regard of the complex interplay between physical restrictions, motor disabilities, sedentary lifestyles and low participation in physical activity, an innovative exercise intervention study for adolescents with CP is intended in order to break the stated vicious cycle. This study aims at providing a novel and inclusive approach in how therapy for adolescents with CP is administered, with the main goal of examining the effects of a functional exercise intervention on motor capability and motor capacity.

Conditions
Cerebral Palsy
Being tested
functional exercise training, standard therapy / treatment
Keywords
adolescents with cerebral palsy, functional exercise intervention, motor capability, motor capacity, gross motor function measure (GMFM-66)
Medical subject headings
Cerebral Palsy

What participants receive

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

  • functional exercise trainingOther

    12 weeks functional exercise training twice per week, each session lasting 60 min

  • standard therapy / treatmentOther

    12 weeks standard therapy / treatment

Study groups in NCT04911309
Study groupRoleWhat they receive
Group 1: 12 weeks functional exercise training followed by standard therapyActive comparator12 weeks functional exercise training twice per week, each session lasting 60 min, additionally to standard therapy. Training sessions will be performed in a group-setting consisting of minimum 4 and maximum 8 participants and coached by experienced sport scientists with the supervision of a medical doctor. The exercises will be individually pants and constantly recorded in order to allow a progression over the course of the 12 week-period. The motor tasks and exercises will be tailored to individual capacity by experienced and trained sport scientists and coaches, therefore insuring the participants' safety and a continuous and progressive monitoring of training load. After 12 weeks the groups will switch the intervention method. Group 1 will therefore reassume their standard therapy for 12 weeks.
Receives: Other: functional exercise training; Other: standard therapy / treatment
Group 2: 12 weeks standard therapy / treatment followed by 12 weeks functional exercise trainingActive comparator12 weeks standard therapy / treatment; the standard therapy group receives no additional exercise sessions. After 12 weeks the groups will switch the intervention method. Group 1 will therefore reassume their standard therapy for 12 weeks. After 12 weeks the groups will switch the intervention method. Group 2 will perform the same intervention which Group 1 received over the first course of 12 weeks.
Receives: Other: functional exercise training; Other: standard therapy / treatment

What is being measured

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

  1. Change in Gross Motor Function Measure-66 (GMFM-66)

    assessment tool designed to measure changes in gross motor function over time in children and adolescents with CP. The test consist of the following five dimensions which span the spectrum of gross motor activities: a) lying and rolling; b) sitting; c) crawling and kneeling; d) standing; e) walking, running and jumping. Scores range from 0-3, higher scores denote better performance

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

Secondary outcomes (19)
  1. Change in height of participants

    Change in height of participants will be measured in an upright standing position without shoes using a wall-mounted stadiometer

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  2. Change in body composition

    Change in body composition will be measured by bioelectrical impedance analysis (BIA) using the InBody 270 (InBody Europe B.V., Eschorn, Germany) device

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  3. Change in clinical assessment

    Clinical assessment will be performed for active ankle dorsiflexion, passive range of motion (RoM), spasticity according to the modified Ashworth/Bohannon scale (scale: 0-4). Tests resistance to passive movement about a joint with varying degrees of velocity. Scores range from 0-4, with 5 choices. A score of 1 indicates no resistance, and 5 indicates rigidity.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  4. Change in muscle strength test (scale: 0-5)

    Change in muscle strength test (scale: 0-5) : 0/5 = No visible muscle contraction. 5/5: Full strength

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  5. Change in arterial stiffness

    Measurement of arterial stiffness using the oscillometric method. The mean values of three valid measurements will be calculated

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  6. Change in Six-minute walking test

    The six-minute walking test will be performed between 2 lines set 20m apart. Participants will be instructed to walk as far as possible in 6 minutes.Total distance covered in six minutes as well as heart rate will be recorded.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  7. Change in Handgrip Strength

    Handgrip strength will be assessed using the Leonardo Mechanography GF®. Participants will be asked to hold their writing hand in a 90-degree angle and to squeeze the sensor as hard as possible for a total of 5 s. Participants will perform two valid measurements with 1 min rest in between. Peak strength in N as well as rate of force development (RFD) will be extracted.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  8. Change in Bear Hug Carry

    The bear hug carry will be performed carrying a medicine ball over a 100m distance. Two lines will be marked 20m apart and participants will be asked to walk the distance 5 times as fast as they can while holding the weighted ball in front of their chest. Participants at pre-measurement will be asked to carry the lightest ball (4 lbs). The same weight will be used in M2 as well as in M3 and the duration to walk the distance (in seconds) will be recorded. An additional test at M2 und M3 will be proposed, in which participants may choose an-other weight if they believe to be able to increase the load and repeat the test. This allows the measurement of individual increase in activity capacity. Weight and time will be recorded.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  9. Change in Laying on the ground and standing up (burpees)

    Individuals are to fully lay on the floor (hands, chest and feet) and stand or jump back up (full extension in hips and knees). The total number of repetitions over 60 seconds will be recorded

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  10. Change in Repeated Chair Rising Test (Box Squats):

    The repeated chair rising test will be performed on a force plate (Leonardo Mechanography GF®, Novotec Medical GmbH, Pforzheim, Germany) with a 46cm high locked bench. Starting from a seated position, arms crossed in front of the chest, participants will perform five complete sit-to-stand cycles as fast as possible. Total time of the five repetitions as well as relative power and mean velocity for a cycle will be analyzed

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  11. Change in Isometric Mid-thigh pull

    Isometric Mid-thigh pull (IMTP) is a multi-joint test which measures isometric force and rate of force development (RFD) in the back as well as lower body muscles and is strongly correlated to dynamic performance. Participants will be instructed to pull as fast and as hard as possible for a duration of 5 seconds

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  12. Change in Push Ups

    The push up measures upper body strength (m. triceps brachii, m. pectoralis) and reflects the participants' ability to press and control their own body weight. For a full repetition, participants must start with their arms extended, touch the ground with their chest, and press back into an extended position. To find their 6 Repetition maximum (RM), participants will position their hands on a box with their feet on the floor. As in the squat depth test, depth of the boxes increase in a 10 cm increment. The lower the boxes, the more body weight is transferred on the upper body and must be pressed. Three minutes rest will be granted between trials to ensure complete recovery. The lowest box (or floor) on which 6 full repetitions can be performed will be noted. Box height and increase of active ROM will be analyzed.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  13. Change in Medicine Ball over Bar Lift

    This test measures the ability to lift and heave an object over an obstacle and allows a high trans-fer into daily life (i.e. lifting groceries onto a table or counter). Participants will lift a medicine ball from the ground and drop it over a bar installed in a rack at chest height as many times as possi-ble over 60 seconds, whereby testing personnel will roll the ball back in front of participants feet after every repetition. Weight of MB will be determined individually at M1 and corresponds to a 6 RM (whereby the lightest weight is a 4 lbs ball and the heaviest a 30 lbs medicine ball). Number of repetitions in the given time will be recorded. At M2 and M3, test will be repeated with the same medicine ball. Additionally, a new 6 RM will be determined and in the case of an increase in weight the test will be repeated with the new weight. Weight and number of repetitions will be recorded and increase in work capacity will be calculated.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  14. Change in Seated sled pull

    To assess participants' strength capacity in pulling strength, seated sled pulls will be performed. From a seated position, participants will pull a weighted sled over 20m using their upper body. Participants must pull the entire rope length (20m) without interruption in order for it to be counted as valid. The resistance (weight on the sled) will be increased in every round until failure (cannot pull rope or pull is interrupted). Weight and time of every round will be recorded.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  15. Change in Maximum Power Output

    Maximum power output and anaerobic capacity will be measured on an Assault Bike (Assault AirBike Classic ®, Ostfildern, Germany). Participants will perform a 1-minute all-out test. The resistance increases in line with rotations per minute (RPM). Participants will be instructed to go as hard as they can for the entire minute. Maximum heartrate and mean watt will be recorded and relative watt calculated to measure maximum power output.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  16. Change in Accelerometry

    In order to examine whether the intervention increases activity in daily life, patients will be asked to wear an Actigraph wGT3X-BT around their non-dominant wrist for 7 consecutive days and nights during each measuring phase. This triaxial accelerometer records intensity and duration of acceleration and converts the signals to "activity counts", allowing an analysis of duration and intensity of movement patterns during everyday life.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  17. Change in instrumented gait analysis: temporospatial parameters

    Change in instrumented gait analysis using a motion capture system. Participants will be asked to walk a distance of about 8 m at their self-selected speed. From the 3D gait data, the temporospatial parameters (cadence, stride length, and walking speed) can be calculated.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  18. Change in instrumented gait analysis: Movement Analysis Profile (MAP)

    Change in instrumented gait analysis using a motion capture system. Participants will be asked to walk a distance of about 8 m at their self-selected speed. From the 3D gait data, the Movement Analysis Profile (MAP) can be calculated.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

  19. Change in instrumented gait analysis: Profile Score (GPS)

    Change in instrumented gait analysis using a motion capture system. Participants will be asked to walk a distance of about 8 m at their self-selected speed. From the 3D gait data, the Gait Profile Score (GPS) can be calculated.

    Measured: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)

Timeline

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

  1. First posted3 Jun 2021
  2. Study start25 Mar 2021
  3. Primary completion30 Oct 2022
  4. Study completion30 Oct 2022

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
Other
Allocation
Randomised
Intervention model
Crossover
Model description
This study is designed as a two-armed crossover intervention study with two intervention phases lasting 12 weeks each and three measurement points.
Masking
None (open label)
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04911309
Sponsor's protocol ID
2020-02827; ks20Klaeusler
Status last verified
Jan 2023
First submitted
26 May 2021
Last updated
18 Jan 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Minghetti A, Widmer M, Viehweger E, Roth R, Gysin R, Keller M. Translating scientific recommendations into reality: a feasibility study using group-based high-intensity functional exercise training in adolescents with cerebral palsy. Disabil Rehabil. 2024 Oct;46(20):4787-4796. doi: 10.1080/09638288.2023.2290204. Epub 2023 Dec 2.

    PubMed 38042988

Questions about this trial

What is this clinical trial studying?

A study testing functional exercise training and standard therapy / treatment in people with Cerebral Palsy, run by University Children's Hospital Basel at 1 site in Switzerland.

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 3 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 18 Jan 2023. 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 Switzerland. 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 Gross Motor Function Measure-66 (GMFM-66) (time frame: at baseline (M1), at week 12 (M2: after intervention phase 1) and at week 24 (M3: after intervention phase 2)). 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 NCT04911309, which also lists 1 linked publication.

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 18 Jan 2023.

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