Effects of Lower Extremities Cycling Functional Electrıcal Stimulation Training in Cerebral Palsy
Keywords
Abstract
Description
Cerebral palsy (CP) is a broadly-defined neurological disorder that encompasses brain injury or malformation in a child's brain that occurs before, during, or immediately after birth and results in impaired motor control. Because of the broad definition of CP, people with CP can exhibit a very wide range of symptoms, and no two people with CP will exhibit the same symptoms. However, people with CP generally have difficulty moving parts of their bodies normally because of muscle weakness or paralysis, impaired muscle coordination, and/or spasticity. Impaired motor control can also be accompanied by intellectual impairment, seizures, or sensory impairment.
Physical impairment can severely limit participation in physical activity by people with CP, as is true for anyone with physical impairments. Lack of physical activity can lead to the development of any number of chronic diseases, especially in children with disabilities like CP. Exercise is an effective method for mitigating the negative secondary health effects of neuromuscular diseases like CP, but how can someone with CP exercise despite their impaired motor control, especially when 31% of children with CP have limited walking ability.
Cycling is an exercise that challenges the muscular and cardiovascular systems, potentially leading to improved health, fitness, and well-being. Cycling with functional electrical stimulation (FES) has been primarily used by people with spinal cord injury; improvements have been seen in bone mineral density, muscle strength (force-generating capacity), and cardiorespiratory measures. Recent reports indicated benefits for people after stroke; improvements in strength and motor control were seen when an FES cycling program was added to traditional rehabilitation. However, there have been no reports of FES cycling for children with CP.
Cycling with FES may be a suitable intervention for with CP because the seated position decreases balance demands, and FES can create or augment pedaling forces. Many people with CP may be incapable of generating sufficient forces during cycling to reach the exercise intensity needed for optimal fitness-related outcomes and musculoskeletal benefits.
Dates
| Last Verified: | 06/30/2018 |
| First Submitted: | 06/02/2018 |
| Estimated Enrollment Submitted: | 07/23/2018 |
| First Posted: | 07/25/2018 |
| Last Update Submitted: | 07/23/2018 |
| Last Update Posted: | 07/25/2018 |
| Actual Study Start Date: | 08/31/2014 |
| Estimated Primary Completion Date: | 04/14/2015 |
| Estimated Study Completion Date: | 11/30/2015 |
Condition or disease
Intervention/treatment
Other: intervention group
Other: Physiotherapy
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| Experimental: intervention group intervention group: Cycling Functional Electrical Stimulation & Physiotherapy
Children in intervention group were taken in a therapy program withRT 300 SLSA FES system for cycling functional electrical stimulation training additionly to physiotherapy program including weight shifting, knee and hip strenging and gait training for 8 weeks, 3 sessions in a week and 45 min per session. | Other: intervention group |
| Active Comparator: control group control group: Physiotherapy
Children with cp in control group were taken physiotherapy program including weight shifting, knee and hip strenging and gait training for 8 weeks, 3 times in a week, 45 min per session. |
Eligibility Criteria
| Ages Eligible for Study | 6 Years To 6 Years |
| Sexes Eligible for Study | All |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - cerebral palsy - classified in levels I - II of the Gross Motor Function Classification System (GMFCS) - able to follow and accept verbal instruction Exclusion Criteria: - any orthopaedic surgery or botulinum toxin injection in the past 6 months, - children whose parents refused to participate |
Outcome
Primary Outcome Measures
1. Gait was assessed using a three-dimensional Gait Analysis motion system. [change from baseline gross motor funciton at 8 weeks]
2. Walking energy expenditure measurements were done with breath by breath method. [change from baseline gross motor funciton at 8 weeks]
Secondary Outcome Measures
1. Gross motor function was measured using GMFM. [change from baseline gross motor funciton at 8 weeks]
2. Modified Ashworth (MAS) scale was used to evaluate muscle tone. [change from baseline gross motor funciton at 8 weeks]
3. The 30s Repetition Maximum test was used to assess functional muscle strength of the lower extremities. [change from baseline gross motor funciton at 8 weeks]
4. Balance was assessed with pediatric balance scale (PBS). [change from baseline gross motor funciton at 8 weeks]
5. Dynamic balance was assessed withTime up & go test (TUG). [change from baseline gross motor funciton at 8 weeks]
6. Daily living activity was assessed with Pediatric Evaluation of Disability Inventory. [change from baseline gross motor funciton at 8 weeks]
7. Quality of life was assessed withThe Child Health Questionnaire (CHQ-PF50). [change from baseline gross motor funciton at 8 weeks]
