RecruitingNot ApplicableNCT05571033

Operant Conditioning of the Soleus Stretch Reflex in Adults With Cerebral Palsy

Sponsor

Burke Medical Research Institute

Enrollment

12 participants

Start Date

Sep 30, 2022

Study Type

INTERVENTIONAL

Conditions

Spastic Cerebral Palsy Cerebral Palsy

Summary

12 adults with spastic CP will complete 6 baseline sessions and 24 down conditioning sessions held 3 times/week. All clinical and physiological assessments collected at baseline will be reassessed after study completion, and follow ups after 2 weeks, 1 month and 3 months. The soleus H reflex (electric analogue of the stretch reflex) will be elicited in all sessions. In each session, participants will complete 20 baseline trials and 225 down conditioning trials to decrease the magnitude of the H-Reflex.

Eligibility

Min Age: 18 Years

Inclusion Criteria8

Age 18 and above
Diagnosis of spastic Cerebral Palsy
Gross Motor Function Classification System level I-III
Stable medical background
Current medication will remain unchanged for 3 months
Provides informed consent
can walk at least 10 meters with or without assistive device
meets minimum study procedure requirements (elicitation of H-reflex).

Exclusion Criteria16

Pregnancy
uncontrolled diabetes
weak dorsiflexion
History of cardiac conditions
cognitive deficits that interfere with study procedure and steps for completion
Botox within 2 months of the study
H/O ankle surgeries in affected leg (Dorsal root rhizotomy etc.)
regular use of electrical stimulation to lower extremity muscles
Cochlear or metal implantations on body
No history of seizure after age 2 years
Current use of antiseizure medicines
Any metal or magnetic components in the head (surgical clips, metal work etc.)
Implanted device or cardiac pacemakers (applicable for DS8R too)
Skin disorders
Damaged skin (wounds, broken skin, or recent scar tissue)
Allergy to latex (tape)

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Interventions

BEHAVIORALSpinal reflex conditioning

Each participant will serve as their own control. The intervention is 30 sessions. The first 6 sessions are baseline measures of reflexes. The remaining sessions will engage participants in learning how to decrease their reflex activity in their calf muscle on the more-affected leg. Each intervention visit will involve 20 trials in which participants do not get visual feedback about their performance, then 225 trials with visual feedback.