We propose an instrumented approach, during which the ankle is rotated in a precise and controlled way using a robot manipulator. Using neuromuscular modelling, key neuromechanical parameters as viscosity, stiffness and reflexive torque can be…
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Ankle stiffness (Nm/rad), viscosity (Nms/rad) and reflex activity (Nm/rad)
Secondary outcome
SPAT and AS scores
Background summary
Cerebral Palsy is a perinatal non progressive damage to the brain often
resulting in disorders of posture and movement, characterized by impaired joint
stiffness. Treatment of motor impairments is based on assessment methods with
a number of disadvantages. The used clinical scales are ordinal, subjective and
do not allow for a further discrimination of impaired joint stiffness into its
contributing components
Study objective
We propose an instrumented approach, during which the ankle is rotated in a
precise and controlled way using a robot manipulator. Using neuromuscular
modelling, key neuromechanical parameters as viscosity, stiffness and reflexive
torque can be quantified based on reaction torque and electromyography of lower
leg muscles.
We aim to apply aforementioned procedure to a group of n=40 CP patients and 10
healthy controls within a cross-sectional design to answer the following
questions:
1. Do neuromechanical parameters around the ankle differ between CP patients
and healthy subjects?
2. Doneuromechanical parameters, i.e. tissue stiffness, viscosity and reflex
torque correlate to disorder severity as graded by the Ashworth Scale (AS) and
SPAT (Spasticity Scale).
3. How are aforementioned correlations influenced by test condition, i.e. speed
of joint rotation and knee angle?
Study design
Cross sectional, observational study
Study burden and risks
The risks of the measurements are minimal. The motor is safe guarded against
greater displacements. The motor and other moving or fragile parts are
sufficiently insulated.
The experiment takes in total about 1,5 hour including mounting and demounting
in the set-up, and the clinical testing. Actual measurements will take about
30 minutes. All measurements will be passive, i.e. no effort is required for
patients and subjects. The measurement time may be reduced after interim
analysis (if no effect of knee angle)
Postbus 9600
2300 RC Leiden
NL
Postbus 9600
2300 RC Leiden
NL
Listed location countries
Age
Inclusion criteria
- Diagnosis of spastic cerebral palsy.
- Age between 6 and 18 years.
- Gross Motor Function Scale (GMFCS, see appendix) I, II or III.
Exclusion criteria
Concomitant neurological diseases.
Concomitant orthopedic problems of the lower extremities.
Casting or Botulinum toxin A injections within the previous 4 months.
Orthopedic surgery of the lower leg; orthopedic surgery in other body parts within the previous 12 months.
Tendon and tissue surgery at the lower leg.
Previous Selective Dorsal Rhizotomy or intrathecal Baclofen treatment.
Inability to take prescribed test condition (hip 70°, knee 20° and 90°).
Severe cognitive or language deficits or disturbed behavior interfering with the comprehension of instructions required to participate in the study.
GMFCS IV or V (to exclude disuse or muscle atrophy).
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL32181.058.10 |