Stop Tip-toeing Around Toe-walking

  • STATUS
    Recruiting
  • End date
    Dec 25, 2023
  • participants needed
    50
  • sponsor
    University Children's Hospital Basel
Updated on 25 August 2021

Summary

The purpose of this study is to explore the interplay among nervous-, musculoskeletal-, and psychological systems and how they impact toe-walking behavior, and vice versa.

Sub-Project 1 is to analyze the feasibility of the developed virtual reality (VR) environment, in 10 TD and sCP children respectively. It is assess the effects of VR immersion on predefined static and dynamic stability parameters.

Sub-Project 2: After adjustments have been made following Sub-Project 1 regarding the study procedure, technical factors or the parameters of interest etc., the optimized study procedure is implemented in Sub-Project 2 (20 to 25 TD will be included).

Sub-Project 3: After adjustments have been made following Sub-Project 1 regarding the study procedure, technical factors or the parameters of interest etc., the optimized study procedure is implemented in Sub-Project3 (20 to 25 sCP will be included)

Description

The interplay between the nervous-, musculoskeletal-, and psychological systems and their impact on resulting walking patterns are poorly understood. Children that toe-walk often show poorer levels of static and dynamic stability, leading to a lower quality of life compared to typically develop-ing children (TD). Current research suggests multifactorial adaptations in central and/or peripheral nervous as well as the musculoskeletal system contribute to and result from toe-walk-ing. The purpose of this study is to explore the interplay among nervous-, musculoskeletal-, and psychological systems and how they impact toe-walking behavior, and vice versa. The effect of psychological factors (via the use of a custom-designed virtual reality environment) on static vs. dynamic stability, motor control, coordination (indirect assessment of central nervous system function) as well as reflex control (Hoffmann-reflex, H-reflex, performance of peripheral nervous system) is investigated.

Details
Condition Cerebral Palsy (Pediatric), spastic cerebral palsy, Cerebral Palsy
Treatment Static stability measurement, Dynamic stability measurement
Clinical Study IdentifierNCT04879199
SponsorUniversity Children's Hospital Basel
Last Modified on25 August 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

between the age of 7 and 18 years
who are typically developing
able to stand and walk alone without using assistance or assistive devices
able to place their feet flat on the force platforms
with enough German language skills to follow the instructions
Inclusion Criteria for sCP children
between the age of 7 and 18 years
with the diagnosis of spastic CP or CP similar (both unilateral and bilateral), functionally classified level I or II according to the Gross Motor Function Classification System (GMFCS)
being able to stand and walk alone without assistance or assistive devices
able to place their feet flat on the force platforms
with enough German language skills to follow the instructions

Exclusion Criteria

severe visual, cognitive, or auditory impairments that would interfere with the study instructions and the VR immersion
any vestibular problems (e.g. severe motion sickness)
history of epilepsy, pace-marker or/and electrical pumps (due to possible interference with electrical stimulation)
prior experience of VR to ensure a comparable baseline between subjects
Exclusion Criteria for sCP children
severe visual, cognitive, or auditory impairments that would interfere with the study instructions and the VR immersion
severe knee flexion gait (>45)
walking capacity <50m
botulinum toxin type A treatment (past 6 months)
orthopedic surgery of upper or lower extremities (past 12 months)
any vestibular problems (e.g. severe motion sickness or dizziness)
history of epilepsy, pace-marker or/and electrical pumps (due to possible interference with electrical stimulation)
prior experience of VR as they may already be adapted to VR
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