The Effect of Perturbation Training on Reactive Balance in Children With Cerebral Palsy

NCT07818928 | Completed

• 2 other identifiers: S656721192320N
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this project was to evaluate whether perturbation training influences reflex modulation in children with spastic CP and whether changed reflex modulation leads to improved reactive balance and walking. Reactive balance was trained using rotational perturbations. Reactive balance performance and reactive muscle activity during trained and untrained perturbation conditions were assessed in children with cerebral palsy and typically developing children.

Conditions

Cerebral Palsy (CP); Typically Developing Children

Keywords

Spastic cerebral palsy; Reactive balance; Perturbation training; Balance performance; muscle co-activation

Outcome Measures

Primary Outcomes (2)

• Balance performance

  Balance performance was evaluated as the number of levels the participant was able to complete before and after training. A level was considered successful if the participant was able to maintain balance without stepping in at least five out of eight trials.

  Baseline and after finishing the nine training sessions (3 weeks)

• Co-contraction index

  The co-contraction index (CCI), a measure of muscle co-activation, was computed as the common area below tibialis anterior and respectively lateral gastrocnemius, medial gastrocnemius, and soleus filtered and scaled EMG trajectories averaged over time (equation 1) during rotational and translational perturbations of standing balance. CCI = (∑〖min⁡(〖EMG\_PF,〖EMG\_TA)〗)/(# frames) (Equation 1) with PF referring to lateral gastrocnemius, medial gastrocnemius, or soleus; and # frames the number of data points in the analyzed time interval. The CCI was calculated for each trial over an interval from 0.5s before perturbation onset until 1.5s after perturbation onset. Trials where the participant took a step were excluded. The average CCI across all non-stepping trials was calculated for each level.

  Baseline and after finishing the nine training sessions (3 weeks)

Secondary Outcomes (1)

• Average muscle activity within three time zones

  Baseline and after finishing the nine training sessions (3 weeks)

Study Arms (1)

Perturbation training

EXPERIMENTAL

Perturbation training

Other: Balance training on a moving platform

Interventions

Balance training on a moving platform OTHER

The training intervention consisted of nine sessions (spread over 3 weeks), which took about 30 minutes each. The first and last session immediately followed and preceded respectively the pre- and post-intervention assessments. During one session, three identical blocks of 32 toe-up rotational perturbations were administered. Each block consisted of perturbations with two different difficulty levels (16 trials each). The administered perturbation levels were selected based on the participant's performance in the previous training session (for training sessions two to nine) and pre-intervention assessment (for the first training session). If the participant was able to maintain balance without stepping in at least 80% of the trials, a more difficult level was offered in the next training. When the participant was able to perform all levels, the training was continued by combining both lower and higher levels, in order to train the complete range of perturbation levels.

Perturbation training

Eligibility Criteria

• Age: 5 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Diagnosis of cerebral plasy
• Spasticity as defined by a clinical assessment, in the gastrocnemius muscle
• Aged 5-17 years old
• GMFCS level 1-2

You may not qualify if:

• Presence of ataxia or dystonia
• Cognitive problems that impede measurements
• Severe co-morbidities
• Irritated skin or open wounds where sensors will be placed
• Botox or surgery in the lower limbs in the last six months
• Not be able to stand or walk independently

Sponsors & Collaborators

• Universitaire Ziekenhuizen KU Leuven: lead
• KU Leuven: collaborator

Study Sites (1)

UZ Leuven

Leuven, Vlaams-Brabant, 3000, Belgium

Location

MeSH Terms

Conditions

Cerebral Palsy

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Kaat Desloovere, Prof. dr.

  Department of Rehabilitation Sciences, KU Leuven, Belgium

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr.

Model Details: Both groups (CP and TD) followed the perturbation training (3 weeks - 9 sessions)

Study Record Dates

• First Submitted: September 8, 2026
• First Posted: September 14, 2026
• Study Start: July 26, 2021
• Primary Completion: August 29, 2025
• Study Completion: August 29, 2025
• Last Updated: September 15, 2026

Record last verified: 2026-09

Locations

BE (1)