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CompletedNCT03687619Updated Aug 6, 2020

Cognitive Orientation to Daily Occupational Performance and Conductive Education Approaches on Down Syndrome

An interventional study of CO-OP and Conductive Education in Down Syndrome, Trisomy 21, sponsored by Eastern Mediterranean University. Completed at 1 site in Cyprus. Open to participants aged 7 Years to 18 Years. Per ClinicalTrials.gov, last updated 2020-08-06.

Sponsored by Eastern Mediterranean University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
12
Allocation
Randomized
Ages
7 Years to 18 Years
Sex
All
01

Study summary

This study will be conducted to investigate and compare the effects of Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conductive Education (CE) on fine motor skills, activity, and participation limitations in children with DS. Children with DS aged 7-18 years will be included. Both CO-OP and CE interventions will last 12 weeks and be conducted for 2 sessions per week in the cross-over randomized study. Following 12-week wash-out period, interventions will be changed for each group.

Read the detailed description

Down syndrome (DS) is a chromosomal anomaly characterized by the presence of an extra copy of genetic material on the 21st chromosome. Sensory, motor, cognitive and perceptual impairments can be seen in children with DS. These impairments probably affect the development and learning of their various fundamental and complex actions. Those children experience decreased motor proficiency, reduced social participation and lower life quality.

Fine motor skills are important for children's everyday functioning such as dressing, feeding, bathing, holding objects, cutting etc. In addition, fine motor skills are related to cognitive, social and academic abilities in children.

This study will be conducted to investigate and compare the effects of Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conductive Education (CE) on fine motor skills, activity, and participation limitations in children with DS. Children with DS aged 7-18 years will be included.

Random allocation software will be used to assign CO-OP or CE to participants. Both CO-OP and CE interventions will last 12 weeks and be conducted for 2 sessions per week. Both intervention will be applied as groups including 3-4 children. Following 12-week wash-out period, interventions will be changed for each group. Two meetings before and during the study will be done in order to inform parents about the interventions and their effects. Another investigator who is blind about the groups will conduct the assessments before and after both first and second treatment durations so 4 assessments will be done in total. At the end of whole treatment schedule, a satisfaction form will be asked from the parents for feedback about both interventions.

02

Conditions studied

  • Down Syndrome, Trisomy 21
03

Who can participate

Ages eligible
7 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Children aged between 7 and 18 years
  • Children who can understand cognitive skills given and can verbally communicate
  • Children who can specify at least 3 activities
  • Children who have adequate motivation

Exclusion criteria

Exclusion Criteria:

  • Caregivers or parents who have inadequate cognitive levels for the study progression
  • Children who participate in any physiotherapy/ergo-therapy schedules for at least 3 months
  • Children who have Cognitive Orientation to daily Occupational Performance and Conductive Education program.
  • Children who have other neurological problems (except Down Syndrome)
  • Children who have undergone orthopedic surgery related to upper limbs
  • Children who have other health and behavioral problems which can affect the participation in the study
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Outcomes assessor)
Enrollment
12 participants (actual)

Study arms

  • Experimental
    CO-OP

    Cognitive Orientation to daily Occupational Performance (CO-OP) is a top-down approach. This programme will be conducted as a small group. Each group will averagely have 5 children. The primary investigator will conduct the programmes. It will be one hour session, twice a week, 12 weeks.

    Other: CO-OP

  • Experimental
    Conductive Education

    Conductive Education is a down-top approach. This programme will be conducted as a small group. Each group will averagely have 5 children. The primary investigator will conduct the programmes. It will be one hour session, twice a week, 12 weeks.

    Other: Conductive Education

Interventions

  • OtherCO-OP

    Interventions (from top to down) related to the development of fine-motor skills

  • OtherConductive Education

    Interventions (from down to top) related to the development of fine-motor skills

05

What researchers measure

Primary outcomes

  1. performance quality rating scale

    The PQRS rates performance quality on a 10-point scale, with a score of 1 indicating ''can't do the skill at all'' and 10 indicating ''does the skill very well''. An independent observer rates performances from video recorded trials of each skill at all assessment points.

    Time frame: 12 weeks

Secondary outcomes

  1. Nine Hole Peg Test

    The Nine-Hole Peg Test is a timed dexterity test that evaluates the ability to pick up nine 1¼-inch-long plastic pegs from a shallow dish, place them one at a time into a pegboard, and remove them one at a time back into the dish. The total time to complete the task for each hand will be recorded in seconds.

    Time frame: 12 weeks

  2. Bruininks-Oseretsky Motor Proficiency Test - Brief Form

    It will be used to determine the motor skills of the children. Bilateral coordination, balance, strength and speed-agility will be measured to specify gross motor skills, while fine motor precision, fine motor integration, manual dexterity, and upper limb coordination will be measured for fine motor skills.

    Time frame: 12 weeks

  3. Canadian Occupational Performance Measure

    The COPM is an outcome measure that, through a semi-structured interview, is designed to (a) identify and prioritize occupational performance issues or goals, and (b) measure clients' self perceived changes in occupational performance and satisfaction with their performance over time, of identified goals.

    Time frame: 12 weeks

  4. Dynamic Performance Analysis

    DPA is a dynamic, iterative process, carried out as the client performs the occupation. The purpose of DPA is to identify where performance breaks down and test out solutions.This analysis will be used within the concept of CO-OP.

    Time frame: 12 weeks

  5. Child Health Questionnaire- Parent Form

    The CHQ PF-50 is a 50 item, parent-completed questionnaire designed to measure the physical and psychosocial well-being of children with and without chronic conditions. Reliability and validity of Turkish version have been shown. The CHQ PF-50 measures components of physical and psychosocial functioning in 12 categories (subscales). The subscales used for our analyses included: physical functioning, role/social limitations (note: we call this subscale "School \& Friends" since it measures the degree to which schoolwork or activities with friends are limited due to problems with physical health), bodily pain/ discomfort, mental health, and self-esteem.

    Time frame: 12 weeks

  6. Goal Attainment Scaling

    The goal attainment scale is characterised by five levels of achievement. The expected outcome is the middle or 'zero' score. This expected outcome is determined first and then two better and two worse outcomes are documented. It enables individualised goals to be set and allows measurement of clinically important change which may not be detected by standardised assessments

    Time frame: 12 weeks

  7. Parent Satisfaction Form

    It is a semi-structured questionnaire which will indicate the satisfaction level of parents from both approaches.

    Time frame: 12 weeks

06

Study locations

1 site
  • Eastern Mediterranean University
    Famagusta, 99628, Cyprus
07

Registry details

Key details

Study ID
NCT03687619
Lead sponsor
Eastern Mediterranean University
Responsible party
Hülya Özbeşer (PT. Ms, Eastern Mediterranean University) — Principal investigator
First posted
Sep 27, 2018
Start date
Mar 5, 2019
Primary completion
Dec 22, 2019
Completion
Aug 1, 2020
Last update
Aug 6, 2020

Study contacts

Emine H. Tüzün, Prof. Dr.
principal investigator · Instructor
Hülya Özbeşer, MSc. PT
principal investigator · Instructor
Levent Eker, M. D.
principal investigator · Instructor

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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