Effect of Motor Imagery Training on Gait and Balance in Children With Spastic Hemiplegia

Cairo University (CU)

Status: Unknown

Conditions: Cerebral Palsy, Spastic

Treatments: Other: Motor imagery training program; Other: Selected physical Therapy program

Study type: Interventional

Funder types: Other

Identifiers

NCT04765917

Ekamal_phd2021

Details and patient eligibility

About

This study aims to:

• Investigate the effect of motor imagery training on gait kinematics in children with spastic hemiplegia.
• Determine the effect of motor imagery training on balance in children with spastic hemiplegia.
• Assess the effect of motor imagery training on trunk endurance in children with spastic hemiplegia.

Full description

Children with spastic hemiplegia may experience a variety of concomitant health conditions including, movement difficulty, postural and balance instability, muscle spasticity, difficulty with motor planning and control, and cognitive impairments.

Postural and balance disturbances occur due to the difficulty in maintaining the body segments aligned on narrow base of support and there is limitation in balance recovery in hemiplegic children contributing to delayed responses of ankle muscles, inappropriate sequencing, and increased coactivation of agonists/ antagonists muscles.

Treatment will vary depending on the severity of impairments, level of activity, participation, and on the priorities highlighted by the patient. Walking is often identified as a main goal, and there is evidence that children with hemiplegia can take steps before regaining standing balance, which would support early walking. Many advanced treatment approaches are used to help improve motor function and gait in patients with hemiplegic CP.

Rehabilitation techniques are predominantly focused on alleviating the compromised motor execution facet of action performance, and have not specifically targeted the motor preparation or planning processes. Motor imagery is proposed to be a backdoor mechanism to access the motor system. It being a theoretically feasible method to activate the immature networks involved in motor control. Therefore, for individuals with motor planning problems this cognitive MI training may be useful to improve motor skills.

Although it has been shown to be beneficial in adult patients with stroke, and it still awaits empirical testing in young children with CP.

Despite the potential benefits of motor imagery training, clinical use of motor imagery training for improving walking and balance abilities is not yet common compared with other conventional modalities in rehabilitation of children with hemiplegia. Consequently, more research and further confirmation are needed regarding the impact of motor imagery training on the gait performance, balance and trunk endurance in children with hemiplegia. Therefore, the purpose of this study to investigate the effect of motor imagery training on balance and kinematic parameters of gait in children with hemiplegia.

Enrollment: 50 estimated patients

Sex: All

Ages: 7 to 10 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Their chronological age will be ranged from 7-10 years.
• Their motor function will be at level I according to according to Gross Motor Function Classification System GMFCS (Palisano et al., 2008).
• The degree of spasticity for these children will ranged from grade 1 to 1+ according to Modified Ashworth Scale (Bohannon and Smith, 1987).
• They will be able to follow instructions during evaluation and treatment.

Exclusion criteria

Children will be excluded from the study if they have:

• Cardiovascular or respiratory disorders.
• Botulinium muscular injection in the last 6 months
• Surgical interference in lower limbs.
• Musculoskeletal problems or fixed deformities in the spine and/or lower extremities.
• Seizures.
• Visual or hearing impairment.
• Mentally retarded children

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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50 participants in 2 patient groups

Selected Physical Therapy group

Active Comparator group

Description:

The Control group will receive a selected physical therapy program for 60 minutes, 3 times/week for 3 successive months including the following exercises

Treatment:

Other: Selected physical Therapy program

Motor imagery training

Experimental group

Description:

Children allocated to the study group will receive the same selected physical therapy program given to the control group for 30 min in addition to 30 minutes motor imagery training program

Treatment:

Other: Selected physical Therapy program

Other: Motor imagery training program