Targeted Muscle Activation During Strength Training for Children With CP
ConditionCerebral Palsy (CP)
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age5-12
SponsorUniversitaire Ziekenhuizen KU Leuven
About this trial
Cerebral palsy (CP) is the most common cause of physical disability in children and is associated with muscle weakness, spasticity, and impaired motor control. These impairments often lead to compensatory movement strategies, in which other muscles are recruited or movements are adapted to offload weaker target muscles. Although lower limb strengthening is widely used to improve motor function in children with CP, outcomes remain inconsistent. One potentially important but rarely examined factor is whether the intended muscles are actually activated during training. This study aims to develop and apply an activation-driven assessment protocol that combines individualized exercise selection, real-time electromyography (EMG) biofeedback, and compensation monitoring to identify conditions that promote target-muscle activation while limiting compensatory mechanisms. The focus is on three key muscle groups: hip extensors (HE), knee extensors (KE), and plantar flexors (PF). In this prospective\[JV2.1\], within-subject repeated-measures study, 30 ambulant children aged 5-12 years with spastic CP and Gross Motor Function Classification System levels I-III will complete three assessment visits in which exercise conditions and feedback strategies are compared using surface EMG and three-dimensional movement analysis.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Confirmed diagnosis of spastic cerebral palsy
Aged 5 - 12 years at the time of inclusion
GMFCS level I - III
At least 3 months post-injection with Botulinum neurotoxin in muscles relevant to the target or compensatory activation patterns (rationale: there is no expected residual neuromuscular effect of Botulinum neurotoxin injections on muscle activation patterns ≥3 months post Botulinum neurotoxin injection)
Disqualifiers
Dyskinetic or ataxic cerebral palsy
Severe spasticity (Modified Ashworth ≥3)
Severe bony deformities or comorbidities precluding valid assessments
Insufficient ability to understand instructions or cooperate with the assessment procedures.
Trial population
Children with spastic cerebral palsy, who have routine follow-up care at the CP reference center of the university hospitals Leuven
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Not listed
Trial groups
30 Participants
are grouped into 1 trial groupGroup A: Children with cerebral palsy
Trial outcomes
Primary outcomes
1
Peak EMG amplitude of the target muscles
Peak normalized EMG amplitude during the exercise, used as a measure of maximal targeted activation of the hip extensors (HE), knee extensors (KE), and plantar flexors (PF).
Time frame
Assessed across three study visits over approximately 4 weeks.2
Integrated EMG of the target muscles
Integrated normalized EMG over the duration of the complete task or phase of interest, used as a measure of total targeted muscle activation.
Time frame
Assessed across three study visits over approximately 4 weeks.3
Co-activation index
Quantification of simultaneous activation of the target muscle and relevant antagonist or compensatory muscle, used to assess co-activation during strengthening exercises. It is calculated as: Co-activation index (%) = 2 × (Common Area of A and B / (Area of A + Area of B)) × 100 where A and B represent the two muscles being compared. Values range from 0% to 100%, with higher values indicating greater simultaneous muscle activation (co-activation).
Time frame
Assessed across three study visits over approximately 4 weeks.4
Selectivity ratio
Integrated EMG of the point-by-point ratio between the time-normalized activation waveform of the target muscle and the corresponding activation waveform of a relevant synergistic or compensatory muscle, used as a measure of target muscle selectivity during the exercise.
Time frame
Assessed across three study visits over approximately 4 weeks.Secondary outcomes
1
Continuous EMG waveforms
Time-normalized EMG waveforms of target, antagonist, and compensatory muscles across the full exercise cycle and relevant task phases.
Time frame
Assessed across three study visits over approximately 4 weeks.2
Continuous joint angle waveforms
Time-normalized joint angle waveforms across the full exercise cycle and task-specific phases. Values are expressed in degrees (°) and reported over 0-100% of the exercise cycle.
Time frame
Assessed across three study visits over approximately 4 weeks.3
Continuous joint moment waveforms
Time-normalized joint moment waveforms across the full exercise cycle and task-specific phases. Values are expressed in Nm/kg and reported over 0-100% of the exercise cycle.
Time frame
Assessed across three study visits over approximately 4 weeks.4
Continuous joint power waveforms
Time-normalized joint power waveforms across the full exercise cycle and task-specific phases. Values are expressed in W/kg and reported over 0-100% of the exercise cycle.
Time frame
Assessed across three study visits over approximately 4 weeks.Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Source ClinicalTrials.gov
This trial is not recruiting at the moment. You can still explore other options: