An interventional study of Instrument Assisted Soft Tissue Mobilization and Stretching Exercises in Cerebral Palsy, sponsored by Istanbul University - Cerrahpasa. Status unknown at 1 site in Turkey. Open to participants aged 5 Years to 18 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-09-13.
Sponsored by Istanbul University - Cerrahpasa · Not applicable, Interventional, and Treatment
The aim of the study; To investigate the effects of Instrument Assisted Soft Tissue Mobilizations and Stretching Exercises on flexibility, spasticity, balance and functional mobility in patients with CP.
Various intervention studies; reported positive results with EDYDM after carpal tunnel syndrome, myofascial trigger point, chronic low back pain, nonspecific thoracic spine pain, ankle instability, mastectomy and total joint arthroplasty. Observational studies have shown positive results in improving posterior shoulder range of motion, hip, knee, and ankle ROM.
There is no study in the literature with EDYDM in patients with CP. Many of the problems in which EDDM is applied for fascia and muscle mobilization in different diseases are also seen in patients with CP. In current rehabilitation methods, Stretching Exercises are applied for muscle and fascia shortening. The advantages of the applications over each other are unknown. Our study is planned as a study with high original value as it is the first study to be conducted using EDYDM in cases with CP. In our study, the effectiveness of EDYDM treatment, which will increase the effectiveness of stretching exercises in CP or can be an alternative treatment approach in cases with CP, will be compared with Stretching Exercises.
751 studies on the registry are indexed under Paralysis; 134 are open to participants now.
This study's planned enrollment of 39 is above the median of 30 across 538 interventional studies indexed under Paralysis.
Browse Paralysis studies →Istanbul University - Cerrahpasa is the lead sponsor of 680 studies on the registry; 208 are open to participants now.
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Exclusion Criteria:
Group 1 (n=13): Each session will consist of 40 minutes. An additional 10 minutes of IASTM will be performed to the 30-minute NDT program.
Other: Instrument Assisted Soft Tissue Mobilization
Group 2 (n=13): Each session will consist of 40 minutes. In addition to the NDT program applied for 30 minutes, 10 minutes of Stretching Exercises will be performed.
Other: Stretching Exercises
Group 3 (n=13): Each session will consist of 40 minutes. There will be no additional application to the NDT program, which is applied for 40 minutes, and it will be included as a control group in the study.
Other: Control Group / NDT program
* This technique will be performed using instruments of different sizes, shapes and treatment styles. * During the application, instruments will be applied to loosen the muscle tissue and fascia by gliding on the tissue at certain angles. * The muscle groups to be treated with IASTM are gastrocnemius, soleus and tibialis posterior. It will also be applied to the superficial and deep fascia. * The instrument will be sterilized before treatment. * IASTM treatment will be applied without damaging the tissue after massaging cream is applied to the muscle fibers with the instrument.
* The muscle groups to be applied stretching exercises are gastrocinemius, soleus and tibialis posterior. It will also be applied to the superficial and deep fascia. * 3 different functional stretching exercises will be applied; * With the hands supported on the wall and with the help of the physiotherapist, the affected extremity is behind the knee in full extension m. gastrocnemius stretching exercise, * With the hands supported on the wall and with the help of the physiotherapist, the knee is partially flexed, with the affected extremity behind. soleus stretching exercise, * It is a stretching exercise that will be applied by asking the patient to squat without lifting his heels, with the patient's hands supported by the physiotherapist.
* Efforts to eliminate tone disorders, * Sensory-perception-motor integrity development studies, * Activities aimed at facilitating movements in daily life, * Stretching and strengthening exercises due to muscle shortness and weakness, * Studies to increase lower and upper extremity functionality, * It will include the training of activities such as standing up, walking and balance.
Modified Ashworth Scale (MAS)
In the evaluation of the presence of spasticity in patients with CP, the ankle plantar flexors will be based. It is recorded as an assessment of the resistance encountered while passively moving the limb at full range of motion. It is scored as 0, 1, 1+, 2, 3, 4. A value of 0 is the best score without muscle tone increase, while a value of 4 is when the extremity is in a rigid position. Modified Ashworth Scale (MAS) will be used to evaluate spasticity.
Time frame: one month
Pediatric Berg Balance Scale (PBBS)
The Pediatric Berg Balance Scale, which is the version of the Berg Balance Scale designed for children by Franjoine et al., will be used to evaluate their functional balance in activities of daily living. The scale consists of 14 sections and each section is scored between 0-4; The highest score that can be obtained from the scale is 56.
Time frame: one month
Selective Motor Control Test (SMCT)
Ankle dorsiflexion Selective Motor Control Test will be used in the evaluation of selective movements. This test evaluates the isolated dorsiflexion movement of the ankle and is evaluated between 0-4 according to the selectivity of the ankle dorsiflexion movement in the long sitting position.
Time frame: one month
Weight-Bearing Lunge Testi (WBLT)
In order to measure the weight-bearing dorsiflexion ROM, the Weight-Bearing Lunge Test, which is positioned with support from the wall in the closed chain position, will be applied. An increase in ankle dorsiflexion angle will be considered as a positive result.
Time frame: one month
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Istanbul University - Cerrahpasa