Diplegic Spastic Cerebral PalsyIASTM;NDT;CPNCT06702709

Comparing the Instrument-Assisted Soft Tissue Mobilization and Neurodevelopmental Therapy for Gross Motor Functions, Muscle Tone and Spasticity in Children with Spastic Diplegic Cerebral Palsy (GMFCS Levels I and II)

A study testing Instrument Assisted Soft Tissue Mobilization and Neurodevelopmental Therapy in people with Diplegic Spastic Cerebral Palsy, run by Ziauddin University at 1 site in Pakistan.

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

Who is it for?: Ages 4 to 12 years
Conditions the study is for: Diplegic Spastic Cerebral Palsy
What is being tested?: Instrument Assisted Soft Tissue Mobilization and Neurodevelopmental Therapy
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 60 participants
Where: 1 sitePakistan
Study dates: 15 Apr 2024to 31 Aug 2024
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 4 to 12 years
All sexes
No healthy volunteers
Child

Who may be able to join

Individuals with diagnosed Diplagic cerebral palsy are referred by a physician
Age 4-12 years.
Children with mild to moderate spasticity according to the Modified Ashworth scale (grade 1, 1+).
Children with GMFCS level-I and II will be included.
Children with pseudomyostatic contractures

Who cannot join

Localized infectious disease.
Inflammatory skin condition.
Diagnosed soft tissue injury of hamstring/gastrocnemius.
Open wound.
Osteomyelitis
Children with a history of any lower limb surgical intervention.
Sensory impairments especially in lower extremities.
History of botulinum toxin injections within 4 months before study entry .

Trial locations and contacts

1 site in 1 country.

Pakistan1 site

Ziauddin College of Physical Therapy
Karachi, Sindh, 74500

Other trials in Pakistan

About this study

Official title: EFFECTS of INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION VS. NEURODEVELOPMENTAL THERAPY on MOTOR FUNCTION in CHILDREN with GMFCS LEVEL I and II SPASTIC DIPLEGIC CEREBRAL PALSY

Cerebral palsy is a neurological condition that affects individuals worldwide, with a global burden of 0.9%. However, prevalence rates show regional variation, with high-income countries reporting rates of 0.2% and low-income countries of 0.3%. In Pakistan, cerebral palsy is the third most common (10.5%) neurological condition in the child population, with a significantly higher frequency of 1.22 per 1000 live births. Amongst the various subtypes of cerebral palsy, spastic diplegic cerebral palsy and spastic quadriplegic cerebral palsy are the most prevalent, accounting for 39% of cases, followed by athetoid (3.34%) and ataxic (10.1%) cerebral palsy in Pakistan.

Individuals with spastic diplegic cerebral palsy exhibit distinct characteristics, including increased muscle tone, scissoring of the lower extremities, and functional impairment. Scissors in the lower limbs, a common manifestation in spastic diplegic cerebral palsy, often result from of hamstring and gastrocnemius hypertonia. The modified Ashworth scale is a sensitive and reliable tool commonly used to assess hypertonicity. This condition primarily results from spasticity caused by upper motor neuron lesions, resulting in excessive alpha motor neuron activity that increases the stretch reflex and muscle tone. Fortunately, spastic diplegic cerebral palsy can be managed with various pharmacological and non-pharmacological approaches.

Pharmacological management includes the use of oral baclofen and botulinum toxin injections. Surgical interventions such as intrathecal baclofen and muscle lengthening procedures are also used to reduce spasticity. However, physical therapy plays a vital role in the management of spastic diplegic cerebral palsy and is critical to improving outcomes for affected individuals. Various physical therapy approaches have been used effectively, including neurodevelopmental therapies, strengthening, passive stretching, strength training combined with stretching, restriction-induced movement therapy and targeted motor reduction programs. Despite their effectiveness, these methods have inherent limitations, such as the limited range of motion with the balance ball, the long time required for motion limitation therapy, and the discomfort associated with stretching exercises. Additionally, differences in practices between therapists were observed.

To address these limitations and improve therapeutic outcomes, the concept of "Instrument Assisted Soft Tissue Mobilization (IASTM)" was introduced. IASTM is a skilled technique involving the use of specialized tools to manipulate the skin, myofascia, muscles, and tendons using direct compression stroke techniques. The application of IASTM tools helps release soft tissue with myofascial adhesions, leading to pain relief, improved range of motion, and improved function. In the context of cerebral palsy, the IASTM is a promising approach, affecting two-point discrimination, pressure pain threshold, and local temperature. In addition, IASTM can promote connective tissue remodeling by breaking down scar tissue, adhesions, and fascial restrictions. In addition, it has been shown to reduce muscle tone by stimulating mechanoreceptors that activate inhibitory interneurons in the spinal cord, leading to decreased activity of alpha motor neurons in extrafusal fibers.

Despite evidence supporting the beneficial impact of IASTM on the special needs population, there is still a paucity of literature on the use of IASTM tools and their effects, particularly for individuals with cerebral palsy. To the best of our knowledge, the use of IASTM is a novel therapeutic approach in the cerebral palsy population of Pakistan to manage muscle tone, range of motion of knee extension and ankle dorsiflexion, and gross motor function. Therefore, this study aims to explore the potential benefits of IASTM in this specific population and aims to provide valuable insights for future research and therapeutic interventions.

Read the detailed description

A total of 60 participants were recruited for this study after obtaining informed, voluntary assent from the guardians of the participants. Each participant was randomly allocated to group A (n=30), which received Instrument Assisted Soft Tissue Mobilization (IASTM), or group B (n=30), which received neurodevelopmental therapy (NDT). Moreover, the envelope method of simple random sampling was used for group allocation, ensuring that the participants remained blind to their group assignment.

Each participant underwent a baseline assessment before starting the intervention, which lasted 4 weeks. After the 4-week intervention period, the interventions were stopped while standard physical therapy continued, and participants were assessed to measure the immediate effects of both IASTM and neurodevelopmental therapy. Subsequently, a follow-up assessment was carried out at week 8 to evaluate any residual effects of the interventions.

During the study, three participants from the IASTM group and eight participants from the NDT group dropped out, resulting in final groups of 27 participants in group A and 22 participants in group B, respectively. The outcome measures included the Modified Ashworth Scale for hypertonicity assessment, the Universal Goniometer for range of motion (ROM) of knee extension and ankle dorsiflexion, and dimensions D and E of GMFM-88 for evaluating gross motor skills.

Conditions: Diplegic Spastic Cerebral Palsy
Being tested: Instrument Assisted Soft Tissue Mobilization, Neurodevelopmental Therapy
Keywords: Cerebral Palsy, GMFM, Spasticity
Medical subject headings: Cerebral palsy, spastic, diplegic, Cerebral Palsy, Muscle Spasticity

What participants receive

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

Instrument Assisted Soft Tissue MobilizationOther
Also called IASTM
The IASTM method will be applied bilaterally to each target muscle, duration 25 minutes. During treatment, three repetitions are performed on each target muscle, with each repetition lasting 50 seconds. The IASTM technique will be applied at a 60-degree angle. The application sequence follows a specific pattern: For the first 10 seconds, light pressure will be applied during the sweeping stroke, and for the next 20 seconds, moderate pressure will apply during the fanning and brushing strokes. Finally, 10 seconds of deep pressure will administer utilizing oblique sweeping strokes. To help the tissues relax, the treatment will finish with mild sweeping and broad strokes on the hamstring region for 10 seconds
Neurodevelopmental TherapyOther
Also called NDT
The neurodevelopment therapy for spastic diplegic cerebral palsy includes tone-inhibitory postures. This study will use five-tone inhibitory postures that will be appropriate for the reduction of muscle tone, elongation of lower extremities muscles, and improve gross motor function by enhancing balance and stability. The following posture will be repeated 3 times on the bilateral lower limb in one session and maintained for 50 seconds with 60 seconds rest between each posture. The total duration of NDT will be 25 minutes.

Study groups in NCT06702709
Study group	Role	What they receive
Group A	Experimental	The treatment protocol of the IASTM group will consist on the preparation phase, application phase followed by strengthening. The session is given for 40 minutes for 4 weeks and 3 days per week. Receives: Other: Instrument Assisted Soft Tissue Mobilization
Group B	Active comparator	The neurodevelopment therapy for spastic diplegic cerebral palsy includes tone-inhibitory postures. This study will use five-tone inhibitory postures that will be appropriate for the reduction of muscle tone, elongation of lower extremities muscles, and improve gross motor function by enhancing balance and stability. The session is given for 40 minutes for 4 weeks and 3 days per week Receives: Other: Neurodevelopmental Therapy

What is being measured

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

Modified Ashworth scale
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Measured: Baseline
Modified Ashworth scale
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Measured: 4 Week
Modified Ashworth scale
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Measured: 8 Week
Universal Goniometer
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Measured: Baseline
Universal Goniometer
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Measured: 4 Week
Universal Goniometer
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Measured: 8 Week
Gross Motor Function Measure-88
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.
Measured: Baseline
Gross Motor Function Measure-88
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.
Measured: 4 Week
Gross Motor Function Measure-88
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.
Measured: 8 Week

Timeline

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

15 Apr 202431 Aug 2024

First posted25 Nov 2024
Study start15 Apr 2024
Primary completion31 Aug 2024
Study completion31 Aug 2024

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Publications (19)Papers the sponsor has linked to this study.
Other trials for Diplegic Spastic 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: Supportive care
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind
Who is masked: Care provider
Enrolment: 60 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT06702709
Sponsor's protocol ID: 8211223HAREH
Acronym: IASTM;NDT;CP
Status last verified: Mar 2024
First submitted: 19 Nov 2024
Last updated: 25 Nov 2024
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No

Publications

Ramey SL, DeLuca SC, Stevenson RD, Conaway M, Darragh AR, Lo W; CHAMP. Constraint-Induced Movement Therapy for Cerebral Palsy: A Randomized Trial. Pediatrics. 2021 Nov;148(5):e2020033878. doi: 10.1542/peds.2020-033878. Epub 2021 Oct 14.
PubMed 34649982
Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3. doi: 10.1007/s11910-020-1022-z.
PubMed 32086598
Kim J, Sung DJ, Lee J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil. 2017 Feb 28;13(1):12-22. doi: 10.12965/jer.1732824.412. eCollection 2017 Feb.
PubMed 28349028
Kalkman BM, Holmes G, Bar-On L, Maganaris CN, Barton GJ, Bass A, Wright DM, Walton R, O'Brien TD. Resistance Training Combined With Stretching Increases Tendon Stiffness and Is More Effective Than Stretching Alone in Children With Cerebral Palsy: A Randomized Controlled Trial. Front Pediatr. 2019 Aug 13;7:333. doi: 10.3389/fped.2019.00333. eCollection 2019.
PubMed 31456995
Kalkman BM, Bar-On L, Cenni F, Maganaris CN, Bass A, Holmes G, Desloovere K, Barton GJ, O'Brien TD. Muscle and tendon lengthening behaviour of the medial gastrocnemius during ankle joint rotation in children with cerebral palsy. Exp Physiol. 2018 Oct;103(10):1367-1376. doi: 10.1113/EP087053. Epub 2018 Sep 13.
PubMed 30091806
Hilderley AJ, Wright FV, Taylor MJ, Chen JL, Fehlings D. Functional Neuroplasticity and Motor Skill Change Following Gross Motor Interventions for Children With Diplegic Cerebral Palsy. Neurorehabil Neural Repair. 2023 Jan;37(1):16-26. doi: 10.1177/15459683221143503. Epub 2022 Dec 15.
PubMed 36524254
Duffy S, Martonick N, Reeves A, Cheatham SW, McGowan C, Baker RT. Clinician Reliability of One-Handed Instrument-Assisted Soft Tissue Mobilization Forces During a Simulated Treatment. J Sport Rehabil. 2022 May 1;31(4):505-510. doi: 10.1123/jsr.2021-0216. Epub 2022 Feb 2.
PubMed 35108674
Tekin F, Kavlak E, Cavlak U, Altug F. Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children. J Back Musculoskelet Rehabil. 2018;31(2):397-403. doi: 10.3233/BMR-170813.
PubMed 29171980
Simatou M, Papandreou M, Billis E, Tsekoura M, Mylonas K, Fousekis K. Effects of the Ergon(R) instrument-assisted soft tissue mobilization technique (IASTM), foam rolling, and static stretching application to different parts of the myofascial lateral line on hip joint flexibility. J Phys Ther Sci. 2020 Apr;32(4):288-291. doi: 10.1589/jpts.32.288. Epub 2020 Apr 2.
PubMed 32273652
Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165. eCollection 2020.
PubMed 32606703
Rivera-Rujana DM, Munoz-Rodriguez DI, Agudelo-Cifuentes MC. Reliability of the Gross Motor Function Measure-66 scale in the evaluation of children with cerebral palsy: validation for Colombia. Bol Med Hosp Infant Mex. 2022;79(1):33-43. doi: 10.24875/BMHIM.21000094.
PubMed 35086134
O'Sullivan R, Marron A, Brady K. Crouch gait or flexed-knee gait in cerebral palsy: Is there a difference? A systematic review. Gait Posture. 2020 Oct;82:153-160. doi: 10.1016/j.gaitpost.2020.09.001. Epub 2020 Sep 6.
PubMed 32927222
Nahm NJ, Graham HK, Gormley ME Jr, Georgiadis AG. Management of hypertonia in cerebral palsy. Curr Opin Pediatr. 2018 Feb;30(1):57-64. doi: 10.1097/MOP.0000000000000567.
PubMed 29135566
Ayala L, Winter S, Byrne R, Fehlings D, Gehred A, Letzkus L, Noritz G, Paton MCB, Pietruszewski L, Rosenberg N, Tanner K, Vargus-Adams J, Novak I, Maitre NL. Assessments and Interventions for Spasticity in Infants With or at High Risk for Cerebral Palsy: A Systematic Review. Pediatr Neurol. 2021 May;118:72-90. doi: 10.1016/j.pediatrneurol.2020.10.014. Epub 2020 Nov 4.
PubMed 33563492
Yoo M, Ahn JH, Rha DW, Park ES. Reliability of the Modified Ashworth and Modified Tardieu Scales with Standardized Movement Speeds in Children with Spastic Cerebral Palsy. Children (Basel). 2022 Jun 3;9(6):827. doi: 10.3390/children9060827.
PubMed 35740764

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

See locations

Recruiting
Short-Term Effects of Manual Therapy Prior to Neuromotor Therapy in Children With Cerebral Palsy
Cerebral Palsy (CP), Unilateral Spastic Cerebral Palsy
Not yet recruiting
Dual-Task Training in Children With Spastic Diplegic Cerebral Palsy
Spastic Diplegia Cerebral Palsy
Recruiting
Effects of Transcranial Direct Current Stimulation Combined With Virtual Reality on Gait and Self-Esteem in Children With Spastic Cerebral Palsy
Spastic Diplegic Cerebral Palsy
Recruiting
Effects of Transcranial Direct Current Stimulation Combined With Virtual Reality on Balance and Executive Functions in Children With Spastic Diplegic Cerebral Palsy
Spastic Diplegic Cerebral Palsy
Active, not recruiting
Therapeutic Listening for Balance and Trunk Control in Children With Cerebral Palsy
Spastic Diplegic Cerebral Palsy, Cerebral Palsy

All Diplegic Spastic Cerebral Palsy trials

Study at a glance

From the registry record, last updated by the sponsor on 25 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: EFFECTS of INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION VS. NEURODEVELOPMENTAL THERAPY on MOTOR FUNCTION in CHILDREN with GMFCS LEVEL I and II SPASTIC DIPLEGIC CEREBRAL PALSY
ClinicalTrials.gov ID: NCT06702709
Acronym / sponsor ID: IASTM;NDT;CP / 8211223HAREH
Conditions: Diplegic Spastic Cerebral Palsy
Keywords: Cerebral Palsy, GMFM, Spasticity
Study type: Interventional
Recruitment status: Completed
Enrolment: 60 participants (actual)
Lead sponsor: Ziauddin UniversityUniversity, hospital or other
Study start: 15 Apr 2024 (actual)
Primary completion: 31 Aug 2024 (actual)
Study completion: 31 Aug 2024 (actual)
First posted: 25 Nov 2024 (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.

Detailed description

Study design

Primary purpose: Supportive care
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind (care provider)
Number of arms: 2

Arm	Type	Receives
Group A	Experimental	Other: Instrument Assisted Soft Tissue MobilizationThe treatment protocol of the IASTM group will consist on the preparation phase, application phase followed by strengthening. The session is given for 40 minutes for 4 weeks and 3 days per week.
Group B	Active comparator	Other: Neurodevelopmental TherapyThe neurodevelopment therapy for spastic diplegic cerebral palsy includes tone-inhibitory postures. This study will use five-tone inhibitory postures that will be appropriate for the reduction of muscle tone, elongation of lower extremities muscles, and improve gross motor function by enhancing balance and stability. The session is given for 40 minutes for 4 weeks and 3 days per week

Who may qualify

Ages: 4 to 12 years
Sex: All
Healthy volunteers: Not accepted
Age groups: Child

Key inclusion criteria (5 listed)

Individuals with diagnosed Diplagic cerebral palsy are referred by a physician
Age 4-12 years.
Children with mild to moderate spasticity according to the Modified Ashworth scale (grade 1, 1+).
Children with GMFCS level-I and II will be included.
Children with pseudomyostatic contractures

Key exclusion criteria (8 listed)

Localized infectious disease.
Inflammatory skin condition.
Diagnosed soft tissue injury of hamstring/gastrocnemius.
Open wound.
Osteomyelitis

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
Instrument Assisted Soft Tissue MobilizationAlso: IASTMThe IASTM method will be applied bilaterally to each target muscle, duration 25 minutes. During treatment, three repetitions are performed on each target muscle, with each repetition lasting 50 seconds. The IASTM technique will be applied at a 60-degree angle. The application sequence follows a specific pattern: For the first 10 seconds, light pressure will be applied during the sweeping stroke, and for the next 20 seconds, moderate pressure will apply during the fanning and brushing strokes. Finally, 10 seconds of deep pressure will administer utilizing oblique sweeping strokes. To help the tissues relax, the treatment will finish with mild sweeping and broad strokes on the hamstring region for 10 seconds	Other	Group A
Neurodevelopmental TherapyAlso: NDTThe neurodevelopment therapy for spastic diplegic cerebral palsy includes tone-inhibitory postures. This study will use five-tone inhibitory postures that will be appropriate for the reduction of muscle tone, elongation of lower extremities muscles, and improve gross motor function by enhancing balance and stability. The following posture will be repeated 3 times on the bilateral lower limb in one session and maintained for 50 seconds with 60 seconds rest between each posture. The total duration of NDT will be 25 minutes.	Other	Group B

Primary outcome

Modified Ashworth scale
Time frame: Baseline
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Modified Ashworth scale
Time frame: 4 Week
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Modified Ashworth scale
Time frame: 8 Week
The Modified Ashworth Scale is a clinical tool developed to assess muscle tone in people with neurological conditions such as cerebral palsy, spinal cord injury, or stroke.The scale rates muscle tone from 0 to 4, with 0 denoting no increase in muscle tone and 4 denoting affected part is rigid in flexion or extension. In this study the modified ashworth scale give the quantitative evaluation of hamstring and gastrocnemius muscle.
Universal Goniometer
Time frame: Baseline
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Universal Goniometer
Time frame: 4 Week
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Universal Goniometer
Time frame: 8 Week
A universal goniometer is a gadget that is used to precisely measure joint angles and range of motion. Typically, it has two moveable arms, such as rulers, that can be adjusted to accommodate various body regions and angles. This study evaluate the range of motion of Knee extension and ankle dorsiflexion.
Gross Motor Function Measure-88
Time frame: Baseline
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.
Gross Motor Function Measure-88
Time frame: 4 Week
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.
Gross Motor Function Measure-88
Time frame: 8 Week
Gross Motor Function Measure-88 (GMFM-88), a widely accepted clinical assessment tool, has been developed to evaluate and assess gross motor function in children with cerebral palsy. GMFM-88 evaluate a child's ability to perform a variety of gross motor skills, such as lying and rolling, sitting, crawling and kneeling, standing, walking, running, and jumping. It consists of 88 items that are categorized into five dimensions. In this study the author will be going to use walking, running, and jumping that is dimension E.

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 25 Nov 2024.
Background: PubMed 34649982Ramey SL, DeLuca SC, Stevenson RD, Conaway M, Darragh AR, Lo W; CHAMP. Constraint-Induced Movement Therapy for Cerebral Palsy: A Randomized Trial. Pediatrics. 2021 Nov;148(5):e2020033878. doi: 10.1542/peds.2020-033878. Epub 2021 Oct 14.
Background: PubMed 32086598Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3. doi: 10.1007/s11910-020-1022-z.
Background: PubMed 28349028Kim J, Sung DJ, Lee J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil. 2017 Feb 28;13(1):12-22. doi: 10.12965/jer.1732824.412. eCollection 2017 Feb.
Background: PubMed 31456995Kalkman BM, Holmes G, Bar-On L, Maganaris CN, Barton GJ, Bass A, Wright DM, Walton R, O'Brien TD. Resistance Training Combined With Stretching Increases Tendon Stiffness and Is More Effective Than Stretching Alone in Children With Cerebral Palsy: A Randomized Controlled Trial. Front Pediatr. 2019 Aug 13;7:333. doi: 10.3389/fped.2019.00333. eCollection 2019.
Background: PubMed 30091806Kalkman BM, Bar-On L, Cenni F, Maganaris CN, Bass A, Holmes G, Desloovere K, Barton GJ, O'Brien TD. Muscle and tendon lengthening behaviour of the medial gastrocnemius during ankle joint rotation in children with cerebral palsy. Exp Physiol. 2018 Oct;103(10):1367-1376. doi: 10.1113/EP087053. Epub 2018 Sep 13.
Background: PubMed 36524254Hilderley AJ, Wright FV, Taylor MJ, Chen JL, Fehlings D. Functional Neuroplasticity and Motor Skill Change Following Gross Motor Interventions for Children With Diplegic Cerebral Palsy. Neurorehabil Neural Repair. 2023 Jan;37(1):16-26. doi: 10.1177/15459683221143503. Epub 2022 Dec 15.
Background: PubMed 35108674Duffy S, Martonick N, Reeves A, Cheatham SW, McGowan C, Baker RT. Clinician Reliability of One-Handed Instrument-Assisted Soft Tissue Mobilization Forces During a Simulated Treatment. J Sport Rehabil. 2022 May 1;31(4):505-510. doi: 10.1123/jsr.2021-0216. Epub 2022 Feb 2.
Background: PubMed 29171980Tekin F, Kavlak E, Cavlak U, Altug F. Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children. J Back Musculoskelet Rehabil. 2018;31(2):397-403. doi: 10.3233/BMR-170813.
Background: PubMed 32273652Simatou M, Papandreou M, Billis E, Tsekoura M, Mylonas K, Fousekis K. Effects of the Ergon(R) instrument-assisted soft tissue mobilization technique (IASTM), foam rolling, and static stretching application to different parts of the myofascial lateral line on hip joint flexibility. J Phys Ther Sci. 2020 Apr;32(4):288-291. doi: 10.1589/jpts.32.288. Epub 2020 Apr 2.
Background: PubMed 32606703Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165. eCollection 2020.
Background: PubMed 35086134Rivera-Rujana DM, Munoz-Rodriguez DI, Agudelo-Cifuentes MC. Reliability of the Gross Motor Function Measure-66 scale in the evaluation of children with cerebral palsy: validation for Colombia. Bol Med Hosp Infant Mex. 2022;79(1):33-43. doi: 10.24875/BMHIM.21000094.
Background: PubMed 32927222O'Sullivan R, Marron A, Brady K. Crouch gait or flexed-knee gait in cerebral palsy: Is there a difference? A systematic review. Gait Posture. 2020 Oct;82:153-160. doi: 10.1016/j.gaitpost.2020.09.001. Epub 2020 Sep 6.
Related InfoLink provided by the sponsor.
Related InfoLink provided by the sponsor.
Individual participant dataSharing planned: No

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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.

Muhammad Abid Khan study chair

Ziauddin University

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

A study testing Instrument Assisted Soft Tissue Mobilization and Neurodevelopmental Therapy in people with Diplegic Spastic Cerebral Palsy, run by Ziauddin University at 1 site in Pakistan.

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 5 inclusion and 8 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 25 Nov 2024. 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 Pakistan. 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?

Modified Ashworth scale (time frame: Baseline). 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?

On the ClinicalTrials.gov record for NCT06702709, which also lists 19 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 25 Nov 2024; AzTrials last refreshed its copy on 1 Nov 2026.