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ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy

INTRODUCTION: For children with cerebral palsy (CP), who are marginally ambulant, gross motor capacity peaks between 6 and 7 years of age with a subsequent clinical decline, impacting their ability to engage in physical activity. Active Strides-CP is a novel package of physiotherapy targeting body f...

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Autores principales: Sakzewski, Leanne, Pool, Dayna, Armstrong, Ellen, Reedman, Sarah Elizabeth, Boyd, Roslyn N, Elliott, Catherine, Novak, Iona, Trost, Stewart, Ware, Robert S, Comans, Tracy, Toovey, Rachel, Peterson, Mark D, Kentish, Megan, Horan, Sean, Valentine, Jane, Williams, Sian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069600/
https://www.ncbi.nlm.nih.gov/pubmed/36990490
http://dx.doi.org/10.1136/bmjopen-2022-068774
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author Sakzewski, Leanne
Pool, Dayna
Armstrong, Ellen
Reedman, Sarah Elizabeth
Boyd, Roslyn N
Elliott, Catherine
Novak, Iona
Trost, Stewart
Ware, Robert S
Comans, Tracy
Toovey, Rachel
Peterson, Mark D
Kentish, Megan
Horan, Sean
Valentine, Jane
Williams, Sian
author_facet Sakzewski, Leanne
Pool, Dayna
Armstrong, Ellen
Reedman, Sarah Elizabeth
Boyd, Roslyn N
Elliott, Catherine
Novak, Iona
Trost, Stewart
Ware, Robert S
Comans, Tracy
Toovey, Rachel
Peterson, Mark D
Kentish, Megan
Horan, Sean
Valentine, Jane
Williams, Sian
author_sort Sakzewski, Leanne
collection PubMed
description INTRODUCTION: For children with cerebral palsy (CP), who are marginally ambulant, gross motor capacity peaks between 6 and 7 years of age with a subsequent clinical decline, impacting their ability to engage in physical activity. Active Strides-CP is a novel package of physiotherapy targeting body functions, activity and participation outcomes for children with bilateral CP. This study will compare Active Strides-CP to usual care in a multisite randomised waitlist-controlled trial. METHODS AND ANALYSIS: 150 children with bilateral CP (5–15 years), classified in Gross Motor Function Classification System (GMFCS) levels III and IV will be stratified (GMFCS III vs IV, age 5–10 years; 11–15 years and trial site) and randomised to receive either (1) 8 weeks of Active Strides-CP two times/week for 1.5 hours in clinic and one time/week for 1 hour alternating home visits and telehealth (total dose=32 hours) or (2) usual care. Active Strides-CP comprises functional electrical stimulation cycling, partial body weight support treadmill training, overground walking, adapted community cycling and goal-directed training. Outcomes will be measured at baseline, immediately post-intervention at 9 weeks primary endpoint and at 26 weeks post-baseline for retention. The primary outcome is the Gross Motor Function Measure-66. Secondary outcomes include habitual physical activity, cardiorespiratory fitness, walking speed and distance, frequency/involvement of community participation, mobility, goal attainment and quality of life. Analyses will follow standard principles for randomised controlled trials using two-group comparisons on all participants on an intention-to-treat basis. Comparisons between groups for primary and secondary outcomes will be conducted using regression models. A within-trial cost utility analysis will be performed. ETHICS AND DISSEMINATION: The Children’s Health Queensland Hospital and Health Service, The University of Queensland, The University of Melbourne and Curtin University Human Research Ethics Committees have approved this study. Results will be disseminated as conference abstracts and presentations, peer-reviewed articles in scientific journals, and institution newsletters and media releases. TRIAL REGISTRATION NUMBER: ACTRN12621001133820.
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spelling pubmed-100696002023-04-04 ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy Sakzewski, Leanne Pool, Dayna Armstrong, Ellen Reedman, Sarah Elizabeth Boyd, Roslyn N Elliott, Catherine Novak, Iona Trost, Stewart Ware, Robert S Comans, Tracy Toovey, Rachel Peterson, Mark D Kentish, Megan Horan, Sean Valentine, Jane Williams, Sian BMJ Open Paediatrics INTRODUCTION: For children with cerebral palsy (CP), who are marginally ambulant, gross motor capacity peaks between 6 and 7 years of age with a subsequent clinical decline, impacting their ability to engage in physical activity. Active Strides-CP is a novel package of physiotherapy targeting body functions, activity and participation outcomes for children with bilateral CP. This study will compare Active Strides-CP to usual care in a multisite randomised waitlist-controlled trial. METHODS AND ANALYSIS: 150 children with bilateral CP (5–15 years), classified in Gross Motor Function Classification System (GMFCS) levels III and IV will be stratified (GMFCS III vs IV, age 5–10 years; 11–15 years and trial site) and randomised to receive either (1) 8 weeks of Active Strides-CP two times/week for 1.5 hours in clinic and one time/week for 1 hour alternating home visits and telehealth (total dose=32 hours) or (2) usual care. Active Strides-CP comprises functional electrical stimulation cycling, partial body weight support treadmill training, overground walking, adapted community cycling and goal-directed training. Outcomes will be measured at baseline, immediately post-intervention at 9 weeks primary endpoint and at 26 weeks post-baseline for retention. The primary outcome is the Gross Motor Function Measure-66. Secondary outcomes include habitual physical activity, cardiorespiratory fitness, walking speed and distance, frequency/involvement of community participation, mobility, goal attainment and quality of life. Analyses will follow standard principles for randomised controlled trials using two-group comparisons on all participants on an intention-to-treat basis. Comparisons between groups for primary and secondary outcomes will be conducted using regression models. A within-trial cost utility analysis will be performed. ETHICS AND DISSEMINATION: The Children’s Health Queensland Hospital and Health Service, The University of Queensland, The University of Melbourne and Curtin University Human Research Ethics Committees have approved this study. Results will be disseminated as conference abstracts and presentations, peer-reviewed articles in scientific journals, and institution newsletters and media releases. TRIAL REGISTRATION NUMBER: ACTRN12621001133820. BMJ Publishing Group 2023-03-28 /pmc/articles/PMC10069600/ /pubmed/36990490 http://dx.doi.org/10.1136/bmjopen-2022-068774 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Paediatrics
Sakzewski, Leanne
Pool, Dayna
Armstrong, Ellen
Reedman, Sarah Elizabeth
Boyd, Roslyn N
Elliott, Catherine
Novak, Iona
Trost, Stewart
Ware, Robert S
Comans, Tracy
Toovey, Rachel
Peterson, Mark D
Kentish, Megan
Horan, Sean
Valentine, Jane
Williams, Sian
ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title_full ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title_fullStr ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title_full_unstemmed ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title_short ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
title_sort active strides-cp: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069600/
https://www.ncbi.nlm.nih.gov/pubmed/36990490
http://dx.doi.org/10.1136/bmjopen-2022-068774
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