Updated on
What did the project achieve?
“We have completed a pilot study to explore whether a safe and painless type of brain stimulation could help improve the lives of children with cerebral palsy when combined with regular physical therapy,” says Professor Helen Dawes of the University of Exeter (previously at Oxford Brookes University). “While the treatment programme was practical and acceptable for families, the effects were small – meaning that larger studies are needed to further explore the potential benefits of this approach.”
Cerebral palsy is a lifelong condition caused by damage to the brain around the time of birth. Many children with the condition will have difficulty controlling their muscles and movement, often affecting both their arms and legs and affecting their ability to engage in daily activities.
The researchers recruited 27 children with cerebral palsy, aged 10 to 16, to take part in a study to investigate whether a short programme of brain stimulation* could help improve movement and daily functioning. Half of the children received the brain stimulation treatment, while the other half received a ‘sham’ procedure that looked the same but did not deliver electrical stimulation. All participants also received physical therapy exercises for both their arms and legs.
“Around three-quarters of the children completed the treatment programme – and many told us they really enjoyed taking part,” says Professor Dawes. “While many children in both groups noticed improvements after the intervention, we did not find clear differences between the two groups in terms of improvements in arm or leg movement one week after treatment.”
Some participants also had magnetic resonance imaging (MRI) brain scans to explore whether certain brain features might help predict who could benefit most from the treatment. These scans suggested subtle links between better hand function and differences in certain areas of the brain involved in movement, but no relationship with changes in function after the treatment programme.
“Ultimately, this research could contribute to refining non-invasive brain stimulation as part of a comprehensive rehabilitation programme for children with cerebral palsy,” says Professor Dawes. “We hope our experiences will help inform future research to better understand how this approach might contribute to improving children’s movement, independence and quality of life.”
*This treatment involves stimulating areas of the brain by applying a weak electrical current through electrodes attached to their scalp.
This research was completed on
Action Medical Research and the Chartered Society of Physiotherapy Charitable Trust are together funding this study
How are children’s lives affected now?
Cerebral palsy is a lifelong condition caused by damage to the brain before or during birth. Children with the condition develop stiff muscles and bone and joint deformities that can affect their ability to engage in daily activities. The severity of symptoms can vary greatly from child to child.
“Some children with cerebral palsy experience movement problems that affect only one side of their body – while others can be affected mainly in their legs, or in all four limbs,” says Professor Dawes.
A treatment that involves stimulating areas of the brain by applying a weak electrical current through electrodes attached to their scalp could potentially help improve the movement and function of children with cerebral palsy when combined with physical therapy.
“However, no-one has yet explored the effectiveness of combining this technique with physical therapy involving both the arm and the leg, even though many children experience difficulties in both limbs,” says Professor Dawes.
How could this research help?
“Our ultimate goal is to develop an effective new treatment combination that can help improve the lives of children with cerebral palsy,” says Professor Dawes.
The researchers will carry out a pilot study involving children with cerebral palsy to investigate if a short programme of brain stimulation can help to improve movement and function when combined with physical therapy for their arms and legs. Some participants will also have a magnetic resonance imaging (MRI) of their brain before starting the study.
“We will analyse these brain scans to look for features that can help predict who is likely to benefit from the treatment,” says Professor Dawes.
The researchers will also evaluate how easy it is to recruit and retain children on the trial – as well as record any side effects.
“If our results are promising, we hope that they will help guide the design of future larger clinical trials to evaluate the effectiveness of this exciting new form of combined treatment,” says Professor Dawes.
References
- Wimalasundera, N. & Stevenson, V.L., Cerebral palsy. BMJ Practical Neurology 2016; 16:184-194.
- Office for National Statistics. Vital statistics in the UK: births, deaths and marriages – 2018 update. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 23 July 2019]
Research table
Project details
| Project Leader | Professor N Helen Dawes, PhD |
| Location | College of Medicine and Health, University of Exeter Medical School, University of Exeter |
| Project Team |
Dr Melanie K Fleming, PhD
Mrs Rachel Buckingham, MBChB Mr Tim Theologis, MSc PhD FRCS Professor Heidi Johansen-Berg, PhD Dr Dido Green, MSc PhD FRSA Dr Jennifer M Ryan, PhD Dr Cherry B Kilbride, PhD |
| Other Locations |
Department of Sport, Health Science and Social Work, Oxford Brookes University
Welcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust. Paediatric Occupational Therapy, Royal Free London NHS Foundation Trust. Department of Clinical Sciences, Brunel University London. |
| Grant Awarded | |
| Grant Amount | £205,322 |
| Start Date | |
| End Date | |
| Duration | 27 months |
| Grant Code (GN number) | GN2813 |
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