Family-Centered Physiotherapy in Dyskinetic Cerebral Palsy
ConditionCerebral Palsy, Dyskinetic
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age5-18
SponsorHacettepe University
About this trial
This study aimed to examine the impact of family centered, goal-oriented physiotherapy and rehabilitation on body function, activity, participation, and quality of life in severely affected children with dyskinetic cerebral palsy (DCP). The first assessment was conducted and recorded for all patients at the beginning of the study. Subsequently, the study group was taught family centered physiotherapy practices in addition to routine physiotherapy for 10 weeks to be performed at home. The control group only received routine physiotherapy. Weekly remote monitoring, regular meetings, and a second assessment at the 10th week were conducted. The study concluded with all face-to-face assessments.
According to the research protocol, the primary aim of this study was to evaluate the effectiveness of a 10-week family centered physiotherapy application. The goal of this intervention was to improve movement and posture, thereby enhancing daily activities and quality of life. The primary endpoint of the study was to determine the impact of family physiotherapy application taught to families during the 10-week education period.
This study was conducted at the Faculty of Physical Therapy and Rehabilitation, Hacettepe University. This study aimed to structure and define a family centered, goal-oriented, personalized physiotherapy, and rehabilitation application for the treatment of children with cerebral palsy. One of the significant objectives of this study was to examine the effects of this intervention within the framework of the International Classification of Functioning, Disability, and Health (ICF) on body function, activity, participation, and quality of life. The study protocol started with evaluations from patients after obtaining approval from the ethics committees.
The study will be completed within a follow-up period of four months without treatment, including the remote monitoring process. The results of this study aimed to provide valuable information about the effectiveness of family centered physiotherapy application in severely affected children with dyskinetic cerebral palsy.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Being in the age range of 5-18 years
Having a diagnosis of Dyskinetic Cerebral Palsy (DSP) confirmed by a pediatric neurologist
Being classified with a gross motor function level of IV-V using the Expanded and Revised Gross Motor Function Classification System (GMFCS E&R)
Having a Manual Ability Classification System (MACS) classification of manual ability level IV-V
Disqualifiers
Having difficulty understanding and following instructions
Having severe visual impairments
Having undergone orthopedic or brain surgery interventions in the last 12 months.
Trial design
Design model
Crossover
Treatments tested in this trial
Family-Centered Goal-Oriented Physiotherapy and Rehabilitation Application
Other interventionFamily centered goal-oriented physiotherapy and rehabilitation applications aim to enhance the functional level of severely affected children with dyskinetic cerebral palsy children through individualized activities conducted by family members at home. The program focuses on specific goals determined collaboratively by the family, physiotherapists, and physician, with regular monitoring and assessments to track progress.
Treatment groups
24 Participants
are divided into 2 treatment groupsGroup A: Experimental Group: Family-Centered Goal-Oriented Physiotherapy and Rehabilitation ApplicationExperimental treatment 1 intervention
Group B: Control Group: Routine Physiotherapy and Rehabilitation ProgramNo intervention 0 interventions
Trial outcomes
Primary outcomes
1
The Gross Motor Function Measure-88; The Gross Motor Function Measure-66
The Gross Motor Function Measure-88 (GMFM-88) and its short form, the Gross Motor Function Measure-66( GMFM-66), assess gross motor function in children, especially those with cerebral palsy. KMFÖ-88 is widely used for comprehensive evaluations in clinical and research settings, whereas GMFM-66-66, a shorter version, focuses on activity measurement based on the International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) to evaluate functional capacity in different positions and activities. A physiotherapist will conduct the assessment through clinical testing and video recordings will be independently evaluated by another researcher.
Time frame
Time frame1: baseline, pre-intervention; Time frame 2: immediately after the interventionSecondary outcomes
1
Dyskinesia Impairment Scale
The Dyskinesia Impairment Scale (DIS) was used to assess the duration and amplitude of distonia and choreoathetosis in 12 body regions, including the eyes, mouth, neck, trunk, and extremities. It provides scores for each region during both action and rest, resulting in a total action score ranging from 0 to 192 and a total rest score ranging from 0 to 96 for both the subscales. The action and rest scores combine to create a total score between 0 and 288, representing the sum of the distonia and choreoathetosis subscales.
Time frame
Time frame1: baseline, pre-intervention; Time frame 2: immediately after the intervention2
Dyskinesia Impairment Mobility Scale
The Dyskinesia Impairment Mobility Scale (DIMS) assesses dyskinesia in motorized wheelchair mobility performance. It has two subscales, Dyskinesia-Dystonia (DIMS-D) and Dyskinesia-Choreoathetosis (DIMS-CA), which use video-based protocols. Each subscale evaluated dyskinesia duration (time during mobility tasks) and amplitude (maximum Range of Motion (ROM) due to dyskinesia) in five motorized mobility tasks. The scores ranged from 0 to 4 for both factors. DIMS assesses overflow movements during mobility tasks and voluntary movements for wheelchair navigation, representing various body regions. The assessment covers the neck and proximal and distal parts of the right and left arms, excluding the feet. DIMS is excluded for assessing the feet due to minimal movement during wheelchair acceleration and braking.
Time frame
Time frame1: baseline, pre-intervention; Time frame 2: immediately after the intervention3
Wong-Baker Faces Pain Rating Scale
The Wong-Baker FACES Pain Rating Scale was employed for pain assessment, particularly for patients aged 3 and above. This validated and recommended scale represents pain levels through facial expressions. The scale ranges from face 0, indicating no pain, to face 5, representing the possibility of the worst pain. The faces expressed increasing levels of pain intensity, with face 1 for mild pain, face 2 for moderate pain, face 3 for severe pain, and face 4 for very severe pain.
Time frame
Time frame1: baseline, pre-intervention; Time frame 2: immediately after the intervention4
Dyskinetic Cerebral Palsy Functional Impact Scale
Dyskinetic Cerebral Palsy Functional Impact Scale (D-FIS) assesses the impact of dyskinesia on daily activities in children with DSP, featuring 18 items, including Pain and Fatigue, and 16 items on daily activities. Parent-proxy completion takes 10 minutes; D-FIS scores on the Impact Scale (0-72) and Priority Scale (1-4) evaluate dyskinesia impact and activity priority. Ratings consider unassisted functions and offer comprehensive evaluation. Higher scores suggest a greater dyskinesia impact, guiding intervention focus on priority areas for children and families.
Time frame
Time frame1: baseline, pre-intervention; Time frame 2: immediately after the interventionSponsors and contacts
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Source ClinicalTrials.gov