The effect of targeted training on function, seated postural control and daily-life activities in children with cerebral palsy

PhD-project

Principal investigator: Derek John Curtis

Principal supervisor: Stig Sonne-Holm

Co-supervisors: Marjorie Woollacott, Jesper Bencke,

Research initiative: Derek John Curtis

Time frame: 2011-2014

Background: Cerebral palsy (CP) is the leading cause of motor disability in children with an incidence of 2 to 2.5 / 1,000 births. CP is defined as “a sensorimotor disorder that affects movement and posture; it appears during the early years of life and is due to a non-progressive disorder of the brain, the result of interference during its development”. In children with CP the development of most motor skills is delayed. This is true for feeding, reach and grasp and object manipulation, which are thought to be impaired due to reduced postural control in the sitting position. Targeted Training is a new form of training aimed at improving postural control. The training has been used in England for 13 years and has seemingly promising clinical results.

Purpose: The purpose of the PhD-project is to investigate (1) the validity and scoring criteria of the Segmental assessment of trunk control (SATCo) test, (2) postural sway and head position in the seated position in healthy children, (3) the effect of TT on postural sway and head position in sitting compared with training as usual (TAU), and (4) the effect of TT on gross motor function and activities of daily living compared with TAU.

Experimental approach: In the first study (study 1), we will include 10 children and adolescents with cerebral palsy and no independent gait function and investigate if it is possible to identify kinematic measurements of sway in the sitting position during a SATCo test with an assessment of the same test carried out from video recordings. Measurements are: Distance velocity and acceleration of markers attached to the head, shoulders and spine of a child during the SATCo test in a movement lab and video scoring of the same SATCo test.

In the second study (study 2) we will include 20 healthy typically developing children between 2 and 16 years old  and measure distance velocity and acceleration of markers attached to the head, shoulders and spine of a child when seated unsupported on a bench viewing a screen with video adjusted to eye height. In the third and fourth study, (study 3 and 4), we include 28 children and adolescents with cerebral palsy and no independent gait function and investigate the effect of 6 months TT compared with 6 months TAU with a 6 month follow. Outcome measures for study 3 will be distance velocity and acceleration of markers attached to the head, shoulders and spine of a child under varying support levels viewing a screen with video adjusted to eye height and their SATCO level. Outcome measures for study 4 will be Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI) and Goal Attainment Scale (GAS).

Additional information: http://clinicaltrials.gov/show/NCT01357954

Contact: derek.john.curtis@regionh.dk


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