Stepping to Understand Lower Limb Impairments in Bilateral Cerebral Palsy

Northwestern University

Status: Active, not recruiting

Conditions: Cerebral Palsy; Diplegic Cerebral Palsy; Bilateral Cerebral Palsy

Treatments: Other: load modulation

Study type: Interventional

Funder types: Other

Identifiers

NCT04957277

STU00214804

Details and patient eligibility

About

The purpose of this study is to investigate lower limb impairments in children with bilateral cerebral palsy during stepping tasks.

Full description

Individuals with bilateral cerebral palsy (BCP) sustain a neonatal brain injury that leads to altered neuromuscular control to the lower limbs. One commonly observed motor impairment from this altered control is loss of selective voluntary motor control (SVMC), defined as the ability to independently move the joints intentionally. Loss of SVMC typically manifests as knee and ankle joint impairment and abnormal coupling between the hip adductors and lower limb extensors. This can make stepping up or down a curb or stair challenging, but quantitative investigation in these closed-chain activities has been limited. This is especially important as performance in stair-climbing is associated with limitations to overall mobility and community participation in cerebral palsy.

The overall aim of this proposal is to investigate the altered neuromuscular control that challenges stair walking in individuals with BCP. Participants who consent to the study will be instructed to perform multiple step-ups and step-downs on a single raised platform. The parameters of the stepping task may change by adding weight to the body or subtracting weight from the body. Using standard gait analysis techniques, biomechanical metrics such as joint kinematics and kinetics will be analyzed.

Enrollment: 30 estimated patients

Sex: All

Ages: 5 to 19 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• aged 5 years to 19 years
• typically developing with no diagnosed medical conditions that affect movement, OR with a diagnosis of bilateral cerebral palsy (including diplegia, tetraplegia, and quadriplegia) where the lower limbs are more affected than the upper limbs
• ability to independently step up, with or without assistive devices.

Exclusion criteria

• lower limb surgery in the past year
• botulinum toxin injections to the lower limb muscles in the past 6 months
• cognitive dysfunction that would make following directions difficult
• comorbidities that would make participation unsafe.

Trial design

Primary purpose: Basic Science

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

30 participants in 1 patient group

load modulation

Experimental group

Description:

Participants will experience different body weight loading conditions - with body weight added by a weighted vest or removed using the ZeroG overhead harness.

Treatment:

Other: load modulation