Spastic DiplegiaNCT03672877
Randomized Controlled Trial of Early Intensive Leg Exercise to Improve Walking in Children With Diplegia
A study testing Intensive exercise in people with Spastic Diplegia and Periventricular Leukomalacia, run by University of Alberta at 2 sites in Canada.
Trial summary
This is a randomized controlled trial, comparing 3 months of intensive leg exercise to standard physiotherapy care for the improvement of gross motor function in young children with spastic diplegia. Read more about this study
- Who is it for?
- Ages 8 to 36 months
- Conditions the study is for
- Spastic Diplegia, Periventricular Leukomalacia
- What is being tested?
- Intensive exercise
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 2 sitesCanada
- Study dates
- 28 Jan 2019to 31 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 8 to 36 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Bilateral motor impairment of the lower extremities
- Periventricular white matter injury from encephalopathy of prematurity
- Able to stand with some support
Who cannot join
- Substantial upper extremity involvement - Manual Abilities Classification System (MACS) Level ≥3
- Uncontrolled epilepsy or infantile spasms in the past 6 months
- Cardiovascular or musculoskeletal complications that preclude participation in intensive exercise
- Botulinum toxin-A (BTX-A) injections in the legs in the last 6 months
Trial locations and contacts
2 sites in 1 country.
Canada2 sites
Alberta Children's Hospital
Calgary, Alberta, T3B 6A8
University of Alberta
Edmonton, Alberta, T6G 2G4
About this study
Official title: Randomized Controlled Trial of Early Intensive Leg Exercise to Improve Walking in Children With Diplegia From Encephalopathy of Prematurity
This is a randomized controlled trial, comparing 3 months of intensive leg exercise to standard physiotherapy care for the improvement of gross motor function in young children with spastic diplegia.
Read the detailed description
Children born prematurely are at risk of brain injury that can result in cerebral palsy, most often affecting both legs. Current treatment is largely passive, including leg braces, repeated injection of a paralyzing agent (botulinum toxin) in muscles that are abnormally active, and surgery as deformities occur. Active, physical therapy for weak muscles is infrequent, occurring twice a month or less. Yet, recent work in mammals show that early brain injury can be alleviated by intensive exercise therapy, but only while the animal is very young.
Building on our success with early, intensive therapy for children with perinatal stroke, we will apply intensive therapy for the legs in children with cerebral palsy involving both legs. Children (8 mo - 3 yr old) will be randomly assigned to start treatment immediately or delay treatment for 6 months. The delay period controls for improvement without treatment. The children in the Delay Group will have the option to receive the same treatment after the delay period. The therapy will be guided by physical therapists, and centered on play. Measures will be taken before, during and after the delay and treatment periods. Measures will include clinical scores of motor development, proficiency of walking, participation at home, and physiological measures of motor and sensory function. All children will be followed until they turn 4 yr old, to determine if there are long term benefits. The cost-effectiveness of the intervention will be evaluated by a health economist. We anticipate that early intensive exercise will improve mobility, facilitate earlier and better walking, and that the effects will be enduring.
- Conditions
- Spastic Diplegia, Periventricular Leukomalacia
- Being tested
- Intensive exercise
- Keywords
- Physical Therapy, Rehabilitation, Walking
- Medical subject headings
- Cerebral Palsy, Leukomalacia, Periventricular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Intensive exerciseBehavioural
Intensive, child-initiated activities of the lower extremities including walking (with or without support), kicking, jumping, standing balance, climbing stairs and slopes and other leg activities. Small weights will be added to the ankle and foot to increase the intensity of the exercise. Sessions will be one hour long, 4 days a week. A physical therapist or designate will supervise sessions.
| Study group | Role | What they receive |
|---|---|---|
| Immediate training group | Experimental | Children will participate in intensive exercise intervention for 3 months and will be followed for 9 months following the intervention Receives: Behavioral: Intensive exercise |
| Delay training group | No intervention | Children will be assessed for 6 months with no intervention. After the 6 month period children will be given the same intervention as the immediate group and followed for 3 months after the intervention. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Gross Motor Functional Measure - 66 Items (GMFM-66)
This is a 66 item criterion-referenced observational measure to assess change in gross motor function of children with cerebral palsy.
Measured: From Baseline to 6 months
Secondary outcomes (2)
Change on Pediatric Quality of Life Measure module for cerebral palsy (PedsQL CP)
A questionnaire format completed by parents including 5 scales: 1) daily activities, 2) movement and balance, 3) pain and hurt, 4) fatigue, and 5) eating activities.
Measured: From Baseline to 6 months
Change in stiffness at the ankle
The portable spasticity assessment device (PSAD) will be used to measure response to stretch in the ankle plantarflexors. A hand-held segment of the device is applied to a limb segment to measure the forces applied by the hand to the limb and the motion of the limb. Disposable, surface electromyographic electrodes are applied to the skin of the limb to measure the muscle activity.
Measured: From Baseline to 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Sep 2018
- Study start28 Jan 2019
- Primary completion31 Mar 2027 (estimated)
- Study completion31 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Spastic DiplegiaStudies of the same condition, open and under way.
- More trials run by University of AlbertaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned to receive 3 months of intervention immediately (Immediate Group) or to be observed for 6 months (Delay Group). Participants in the Delay Group will be offered the intervention once the observation period is complete.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Alberta
- Sponsor type
- University, hospital or other
- Collaborators
- Canadian Institutes of Health Research (CIHR)
- Responsible party
- Sponsor
- Investigators
- Jaynie Yang, Phd, Principal investigator, Universtiy of Alberta
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03672877
- Sponsor's protocol ID
- Pro00080569
- Status last verified
- May 2026
- First submitted
- 13 Sep 2018
- Last updated
- 6 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Controlled Trial of Early Intensive Leg Exercise to Improve Walking in Children With Diplegia From Encephalopathy of Prematurity
- ClinicalTrials.gov ID
- NCT03672877
- Acronym / sponsor ID
- Pro00080569
- Conditions
- Spastic Diplegia, Periventricular Leukomalacia
- Keywords
- Physical Therapy, Rehabilitation, Walking
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- University of AlbertaUniversity, hospital or other
- Collaborators
- Canadian Institutes of Health Research (CIHR)
- Study start
- 28 Jan 2019 (actual)
- Primary completion
- 31 Mar 2027 (estimated)
- Study completion
- 31 Mar 2027 (estimated)
- First posted
- 17 Sep 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a randomized controlled trial, comparing 3 months of intensive leg exercise to standard physiotherapy care for the improvement of gross motor function in young children with spastic diplegia.
Detailed description
Children born prematurely are at risk of brain injury that can result in cerebral palsy, most often affecting both legs. Current treatment is largely passive, including leg braces, repeated injection of a paralyzing agent (botulinum toxin) in muscles that are abnormally active, and surgery as deformities occur. Active, physical therapy for weak muscles is infrequent, occurring twice a month or less. Yet, recent work in mammals show that early brain injury can be alleviated by intensive exercise therapy, but only while the animal is very young.
Building on our success with early, intensive therapy for children with perinatal stroke, we will apply intensive therapy for the legs in children with cerebral palsy involving both legs. Children (8 mo - 3 yr old) will be randomly assigned to start treatment immediately or delay treatment for 6 months. The delay period controls for improvement without treatment. The children in the Delay Group will have the option to receive the same treatment after the delay period. The therapy will be guided by physical therapists, and centered on play. Measures will be taken before, during and after the delay and treatment periods. Measures will include clinical scores of motor development, proficiency of walking, participation at home, and physiological measures of motor and sensory function. All children will be followed until they turn 4 yr old, to determine if there are long term benefits. The cost-effectiveness of the intervention will be evaluated by a health economist. We anticipate that early intensive exercise will improve mobility, facilitate earlier and better walking, and that the effects will be enduring.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned to receive 3 months of intervention immediately (Immediate Group) or to be observed for 6 months (Delay Group). Participants in the Delay Group will be offered the intervention once the observation period is complete.
| Arm | Type | Receives |
|---|---|---|
| Immediate training group | Experimental | Behavioral: Intensive exerciseChildren will participate in intensive exercise intervention for 3 months and will be followed for 9 months following the intervention |
| Delay training group | No intervention | –Children will be assessed for 6 months with no intervention. After the 6 month period children will be given the same intervention as the immediate group and followed for 3 months after the intervention. |
Who may qualify
- Ages
- 8 to 36 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Bilateral motor impairment of the lower extremities
- Periventricular white matter injury from encephalopathy of prematurity
- Able to stand with some support
Key exclusion criteria (4 listed)
- Substantial upper extremity involvement - Manual Abilities Classification System (MACS) Level ≥3
- Uncontrolled epilepsy or infantile spasms in the past 6 months
- Cardiovascular or musculoskeletal complications that preclude participation in intensive exercise
- Botulinum toxin-A (BTX-A) injections in the legs in the last 6 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Intensive exerciseIntensive, child-initiated activities of the lower extremities including walking (with or without support), kicking, jumping, standing balance, climbing stairs and slopes and other leg activities. Small weights will be added to the ankle and foot to increase the intensity of the exercise. Sessions will be one hour long, 4 days a week. A physical therapist or designate will supervise sessions. | Behavioural | Immediate training group |
Primary outcome
Change in Gross Motor Functional Measure - 66 Items (GMFM-66)
Time frame: From Baseline to 6 months
This is a 66 item criterion-referenced observational measure to assess change in gross motor function of children with cerebral palsy.
2 secondary outcomes
Change on Pediatric Quality of Life Measure module for cerebral palsy (PedsQL CP)
Time frame: From Baseline to 6 months
Change in stiffness at the ankle
Time frame: From Baseline to 6 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
Related trials for Spastic Diplegia
Not yet recruiting
Dual-Task Training in Children With Spastic Diplegic Cerebral Palsy
Spastic Diplegia Cerebral Palsy
Active, not recruiting
Effect of Reactive Functional Motor Challenge Training on Dynamic Balance and Functional Mobility in Children With Spastic Diplegic Cerebral Palsy: A Randomized Comparative Trial.
Cerebral Palsy (CP), Spastic Diplegia Cerebral Palsy
Active, not recruiting
Oculomotor Training in Spastic Diplegia: Effects on Postural Stability and Motor Proficiency
Cerebral Palsy Spastic Diplegia
Recruiting
Effects of Proprioceptive Neuromuscular Facilitation and Task-Oriented Training on Upper Extremity Function in Children With Spastic Diplegic Cerebral Palsy
Cerebral Palsy, Spastic Diplegia
Not yet recruiting
Action Observation Therapy in Children With Spastic Diplegia
Spastic Diplegia
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jaynie Yang, Phd principal investigator
Universtiy of Alberta
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Intensive exercise in people with Spastic Diplegia and Periventricular Leukomalacia, run by University of Alberta at 2 sites in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Gross Motor Functional Measure - 66 Items (GMFM-66) (time frame: From Baseline to 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026; AzTrials last refreshed its copy on 6 Nov 2026.