CClinicalTrials.gg
CompletedNCT06170814Updated Dec 31, 2024

Effects of Different Focuses of Attention on Walking and Balance in Children With Cerebral Palsy

An observational study in Cerebral Palsy, Gait, Hemiplegic and Balance, sponsored by Gazi University. Completed at 1 site in Turkey. Open to participants aged 6 Years to 18 Years. Per ClinicalTrials.gov, last updated 2024-12-31.

Sponsored by Gazi University · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
24
Ages
6 Years to 18 Years
Sex
All
01

Study summary

This study was planned to examine the effects of different focuses (external and internal focus)of attention on functional walking and balance in children with cerebral palsy. Individuals with CP between the ages of 6-18 will be included in the research. It was planned to include 24 individuals in total, 12 individuals in each group.

Read the detailed description

In the external focus of attention (EF), attention is directed to movement and an environmental stimulus. In the internal focus (IF), attention is directed directly to body movements. In revealing positive effects in external focus; Methods such as metaphor, analogy, imaginary objects, mental analogies can be used. Adopting an External focus of attention (focusing on the effects of movements on the object or environment), as opposed to an Internal focus of attention (focusing on body movements), has been found to significantly improve performance on a variety of tasks. Walking and balance are essential for activities of daily living and social participation; Therefore, it is often considered one of the most important activities in daily life. Walking and balance is an automatic rhythmic motor behavior controlled mostly by subcortical brain regions. Automaticity means that walking can be performed without requiring attention. Although it seems like a very simple activity, it is actually a very complex chain of movements in which the brain, spinal cord, muscles, bones and joints work together in coordination. However, movement, balance and gait disorders cause individuals with CP to spend more energy, deteriorate their mobility and decrease their independence. Although the beneficial effects of EF have not yet been demonstrated for every population, the constrained action hypothesis encourages the use of an EF for teaching motor skills. Looking at the literature, the effects of EF on the development of motor performance in children with cerebral palsy have not been examined. Therefore, this study aims to examine the effects of external focus of attention on gait and balance.

Individuals with CP between the ages of 6-18 will be included in the research. After the purpose and scope of the study are explained to all individuals and their families who agree to participate in the study, their families will be asked to read and sign the volunteering form. All individuals who meet the inclusion criteria will be randomly divided into 2 groups (external focus and internal focus). It was planned to include 24 individuals in total, 12 individuals in each group. The same evaluations will be made to all individuals participating in the study by a physiotherapist who is an expert in the field. In addition to conventional physiotherapy for 6 weeks, individuals will be included in an exercise program that focuses on external and internal attention for 30 minutes a day, 3 days a week. Evaluation of walking function will be done with the C-Mill Walking Training System. Balance function will be performed by standing on one leg, pediatric berg balance scale and functional reaching tests.Independence Pediatric Functional Independence Scale will be evaluated with.Trunk control, trunk control measurement scale will be evaluated with.

02

Conditions studied

  • Cerebral Palsy
  • Gait, Hemiplegic
  • Balance

Keywords

  • cerebral palsy
  • External focus
  • internal focus
  • gait and balance
03

In context

Paralysis

750 studies on the registry are indexed under Paralysis; 133 are open to participants now.

This study's enrollment of 24 is below the median of 60 across 199 observational studies indexed under Paralysis.

Browse Paralysis studies →

Lead sponsor

Gazi University is the lead sponsor of 532 studies on the registry; 99 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Children with hemiparatic cerebral palsy between the ages of 6 and 18 will be included in the study.

In order to perceive the commands during the exercise, the children participating in the study must have a level of cognitive development to be cooperative.

Inclusion criteria

  • Being diagnosed with spastic type cerebral palsy between the ages of 6-18
  • Volunteerism of the family and individuals to participate in the study
  • Being at levels I and II according to the Gross Motor Classification System
  • Having the cognitive development to be cooperative

Exclusion criteria

Exclusion Criteria:

  • Having undergone any orthopedic and/or neurological surgery in the last 6 months,
  • Having hearing and/or vision loss that would prevent participation in the study.
05

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
24 participants (actual)
Patient registry
No

Groups and cohorts

  • external odak

    Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs and tracks will be built to improve walking and balance functions. During exercises, attention is directed to movement and an environmental stimulus in the external focus of attention.

    Other: Exercise

  • internal focus

    Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs, and tracks will be built to improve walking and balance functions. In internal focus during exercises, attention is directed directly to body movements.

    Other: Exercise

Interventions

  • OtherExercise

    Exercise will be done for approximately 40 minutes, 3 days a week for 6 weeks. Ramps, obstacle jumping, stairs and tracks will be built to improve walking and balance functions. One group will be given external focus stimuli, the other group will be given internal focus stimuli.

06

What researchers measure

Primary outcomes

  1. Gait

    Walking function will be evaluated twice with the C-Mill Walking Training System, before and at the end of treatment (6 weeks of treatment).

    Time frame: 6 week

Secondary outcomes

  1. balance

    Balance function will be evaluated twice, before and at the end of treatment (6 weeks of treatment), with the one-leg standing test and the functional reaching test.

    Time frame: 6 week

  2. Trunk control measurement scale

    trunk control, trunk control measurement scale will be evaluated with.

    Time frame: 6 week

  3. Pediatric Functional Independence Scale

    Independence, Pediatric Functional Independence Scale will be evaluated with.

    Time frame: 6 week

  4. pediatric berg balance scale

    The Pediatric Balance Scale is a modified version of the Berg Balance Scale that is used to assess functional balance skills in school-aged children.

    Time frame: 6 week

07

Study locations

1 site
  • Rabia ERASLAN
    Ankara, Turkey
08

References and documents

Publications

  • Beauchet O, Berrut G. [Gait and dual-task: definition, interest, and perspectives in the elderly]. Psychol Neuropsychiatr Vieil. 2006 Sep;4(3):215-25. French. PubMed 16945851 ↗
  • Yamada M, Raisbeck LD, Porter JM. The Effects of Using Imagery to Elicit an External Focus of Attention. Res Q Exerc Sport. 2021 Sep;92(3):559-565. doi: 10.1080/02701367.2020.1733455. Epub 2020 Mar 6. PubMed 32142388 ↗
  • Bunger A, Urfer-Maurer N, Grob A. Multimethod Assessment of Attention, Executive Functions, and Motor Skills in Children With and Without ADHD: Children's Performance and Parents' Perceptions. J Atten Disord. 2021 Feb;25(4):596-606. doi: 10.1177/1087054718824985. Epub 2019 Jan 30. PubMed 30700232 ↗
  • Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, Rosenblum S, Smits-Engelsman B, Sugden D, Wilson P, Vincon S. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Dev Med Child Neurol. 2019 Mar;61(3):242-285. doi: 10.1111/dmcn.14132. Epub 2019 Jan 22. PubMed 30671947 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 31, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06170814
Lead sponsor
Gazi University
Responsible party
Rabia ZORLULAR (principal investigator, Gazi University) — Principal investigator
First posted
Dec 14, 2023
Start date
Dec 30, 2023
Primary completion
Aug 15, 2024
Completion
Sep 15, 2024
Last update
Dec 31, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Dec 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion