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NCT Number: NCT07617935

Effect of Vestibular Rehabilitation on Postural Sway and Energy Expenditure in Children With Spastic Diplegia

this study will be conducted To determine the effect of vestibular rehabilitation training on postural sway and energy expenditure in children with spastic cerebral palsy and To determine any relation between postural sway and energy expenditure in children with spastic cerebral palsy.

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Key information

Conditions

Spastic Diplegia Brain Damage, Chronic Brain Diseases Central Nervous System Diseases Cerebral Palsy Nervous System Diseases

Age range

8 year–12 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

outpatient clinic, faculty of physical therapy, Cairo university

Cairo, Egypt

Location contact

Nesma Abdelrhman Farag, assistant lecturer

CONTACT

[email protected]

01016612043

About this study

Cerebral palsy leads to postural asymmetries and balance impairments, primarily due to central vestibular dysfunction. Children aged 7-12 with gross motor function classification system levels I-III exhibit poor visual and vestibular interactions, impacting their ability to resolve sensory conflicts and manage reflexes. Excessive lateral trunk lean in cerebral palsy, prevalent in 72% of affected children, increases locomotion costs. Energy expenditure during walking rises with declining motor function, particularly in spastic cerebral palsy where vestibular dysfunction affects nearly 48% of cases. The relationship between balance control efforts and metabolic energy expenditure is complex, especially during dynamic activities like walking. This study will assess the impact of vestibular rehabilitation on postural sway and energy expenditure in children with spastic cerebral palsy, aiming to elucidate their interrelationship.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • The age of the selected children will be ranged from 8 to 12 years old.
  • Degree of spasticity is ranging from 1+to 2 according to modified Ashworth scale
  • The level of motor function of the children will be levels I-II according to Gross Motor Function Classification System
  • They are able to follow instructions and understand commands.

Exclusion criteria

  • Bone and tendon lengthening surgeries within last 6 months.
  • Lung and heart diseases and disorders.
  • Vision or hearing problems
  • Children with fixed deformities.
  • Children with epilepsy.
  • Recent intramuscular Botulinum toxin injection or orthopedic surgery within last 6 months.

Treatment and study plan

Vestibular Rehabilitation

Other
  • Bouncing-jumping activities from standing.
  • linear swinging activities: using swinging platform (standing walking) scooter activity (kneeling, standing), hanging lower limb activities and climbing swinging robe ladder.
  • By pushing-pulling activities, displacement of the center of gravity is created.
  • These are activities which enable active equilibrium on steep surfaces such as stairs.
  • Walking on ramps.
  • Walking unfamiliar surfaces such as balance disc, balance boards and balance beam

Conventional physical therapy

Other
  • Balance exercise.
  • Gait training (forward, backward and side way).
  • Gait training with obstacles of different sizes.
  • Gait training in stepper.
  • Gait training on wooden ramp.
  • Gait training on balance board.
  • Training up and down steps different heights.
  • Stretching exercise for upper limbs and lower limbs.
  • Strengthening exercises for lower limbs muscles.
  • Trunk control exercises like abdominal and back exercises.

Primary outcomes

  1. assessment of postural sway

    Time frame: at base line and after 8 weeks

    The process for measuring frontal plane lateral trunk tilt angle during gait involves several steps as per the studies. First, three circular adhesive dots are placed on the sternal notch and the anterior superior iliac spine. A video camera is set up to capture the child's full body while walking. The recorded video is analyzed using Kinovea, dividing the gait cycle into 11 frames at 10% intervals. The angle of trunk deviation from vertical is calculated in these frames by connecting the anterior superior iliac spine markers and the sternal notch to determine the longitudinal axes of the trunk, with the angle measured against a vertical line.

Secondary outcomes

  1. assessment of Energy Expenditure

    Time frame: at base line and after 8 weeks

    Heart rate expressed per distance walked provides information on energy economy as dose oxygen uptake expressed per distance walked because resting heart rate is known to increase with decreased body size and level of fitness, the resting heart rate is subtracted from the walking heart rate, and this value is divided by the walking speed. The following calculation of an energy expenditure index (energy expenditure index; beats/minute) energy expenditure index heart rate = (exercise heart rate-resting heart rate)/speed measured in m·min

Study contacts

Contact information is provided by the study sponsor or research team.

Nesma Abdelrhman Farag, assistant lecturer

CONTACT

[email protected]

01016612043

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 1, 2026
Registry last updated
Jun 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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