<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03016923</url>
  </required_header>
  <id_info>
    <org_study_id>15-549</org_study_id>
    <nct_id>NCT03016923</nct_id>
  </id_info>
  <brief_title>Functional Electrical Stimulation (FES) for Upper Extremity Hemiplegia in Children With Cerebral Palsy</brief_title>
  <official_title>An Evaluation of the Effectiveness of Functional Electrical Stimulation Paired With Intensive Therapy to Improve Hand Function in Children With Hemiplegic Cerebral Palsy</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Holland Bloorview Kids Rehabilitation Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Holland Bloorview Kids Rehabilitation Hospital</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The proposed pilot study seeks to explore the effectiveness of Functional Electrical&#xD;
      Stimulation (FES) to improve upper limb function in children and youth (aged 6 to 18 years)&#xD;
      with hemiplegic cerebral palsy, as measured by the QUEST grasp score and other secondary&#xD;
      outcome measures obtained pre- and post-intervention in a case series study design.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Functional electrical stimulation (FES) has increasingly gained interest as a therapeutic&#xD;
      intervention for the improvement of motor function in individuals with disabilities. FES&#xD;
      involves the administration of electrical pulses to stimulate motor neurons and initiate&#xD;
      muscle contractions, It has been used primarily for individuals with spinal cord injury or&#xD;
      those who have experienced a stroke leading to the loss of or decreased motor function of the&#xD;
      limbs. The repeated application of FES to the affected limb has been shown to enable&#xD;
      individuals with hemiplegia to voluntarily control movements of the affected upper limb. A&#xD;
      new FES system, has recently been developed and indicated for use for the improvement of arm&#xD;
      and hand function in patients with hemiplegia due to stroke or spinal cord injury. FES is a&#xD;
      non-invasive therapy that involves transcutaneous delivery of electrical stimulation to the&#xD;
      affected upper limb, patient participation and the assistance of therapists to improve&#xD;
      voluntary arm and hand movements such as reaching and grasping.&#xD;
&#xD;
      The new FES system has shown effectiveness in both adults with acute stroke and children with&#xD;
      chronic acquired stroke. In a randomized controlled trial, FES paired with intensive therapy&#xD;
      compared to intensive therapy alone was shown to significantly improve hand function for&#xD;
      adults with acute stroke. Participants in the trial had limited mobility or complete&#xD;
      immobility of the affected arm and those who received FES paired with intensive therapy had&#xD;
      clinically significant improvements in hand movements compared to those who only received&#xD;
      intensive therapy. Recently, transcutaneous FES paired with intensive hand therapy (3&#xD;
      one-hour sessions per week for 16 weeks) has more recently been shown to improve hand&#xD;
      function in children with chronic acquired stroke.&#xD;
&#xD;
      The efficacy of FES seen in patients with stroke opens up the possibility for its use in&#xD;
      other similar populations, including children with hemiplegic cerebral palsy (HCP). However,&#xD;
      there is currently limited research on the efficacy of FES with this population. In a&#xD;
      preliminary study, the use of FES alone over a treatment period of 6 weeks in children with&#xD;
      HCP was shown to significantly improve wrist movement. However, most of the research to date&#xD;
      on the effects of FES on children with HCP has been focused on gait and lower limb function.&#xD;
      There is currently a lack of evidence on the effectiveness of FES paired with intensive&#xD;
      therapy on hand function in children with HCP. FES paired with intensive therapy holds&#xD;
      significant potential to improve the hand function of children with HCP and warrants further&#xD;
      investigation.&#xD;
&#xD;
      Therefore, the proposed research seeks to address two main objectives:&#xD;
&#xD;
        1. To investigate the effectiveness of FES to improve upper limb function in children with&#xD;
           HCP.&#xD;
&#xD;
        2. To assess the effects of FES on upper limb function in children with HCP at six months&#xD;
           post-intervention.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>March 2016</start_date>
  <completion_date type="Actual">August 25, 2017</completion_date>
  <primary_completion_date type="Actual">August 25, 2017</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Quality of Upper Extremities Skills Test (QUEST) as a measure of Movement patterns and hand function</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </primary_outcome>
  <secondary_outcome>
    <measure>Canadian Occupational Performance Measure (COPM) as a measure of change in a child's self-perception of occupational performance over time</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Grip Strength Test as a measure of hand and forearm muscular strength</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Jebsen-Taylor Test of Hand Function (JTTHF) as a measure of hand functions required in activities of daily living</measure>
    <time_frame>Change from Baseline (i.e., prior to intervention), at 4 months post-intervention, and at 6 months post-intervention. JTTHF will also be assessed at 4 weeks, 8 weeks, 12 weeks, and 16 weeks during the intervention period.</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Children's Hand-use Experience Questionnaire (CHEQ) as a measure of children's experience in using the affected hand in bi-manual activities</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Proprioception Task as a measure of joint-position sense</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Two-point Orientation Discrimination (2POD) as a measure of tactile spatial acuity</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Stereognosis Test as a measure of is the ability to recognize and identify common objects through tactile manipulation without the use of visual cues</measure>
    <time_frame>Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention</time_frame>
  </secondary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Actual">3</enrollment>
  <condition>Cerebral Palsy</condition>
  <arm_group>
    <arm_group_label>FES Therapy</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>FES therapy will be administered over the course of 1 hour sessions that will be take place 3 times per week over 16 weeks, for a total of 48 sessions.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>FES Therapy</intervention_name>
    <description>FES therapy will be administered over the course of 1 hour sessions that will be take place 3 times per week over 16 weeks, for a total of 48 sessions.</description>
    <arm_group_label>FES Therapy</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Diagnosis of hemiplegic CP&#xD;
&#xD;
          -  Age between 6 to 18 years&#xD;
&#xD;
          -  Ability to cooperate, understand and follow instructions during the administration of&#xD;
             FES paired with intensive hand therapy&#xD;
&#xD;
          -  Baseline total QUEST score between 20-80 out of 100 points&#xD;
&#xD;
          -  Be seizure-free for a required period of at least 1 year with or without medication ,&#xD;
             and have no prior history of known cardiac arrhythmias/stimulants&#xD;
&#xD;
          -  No pacemaker or implanted metallic or electronic device&#xD;
&#xD;
          -  No edema, skin rash, allergy or wound on the affected upper limb where FES will be&#xD;
             administered.&#xD;
&#xD;
          -  No Botulinum toxin upper limb injections within 6-months of study entry, and no&#xD;
             Constraint-induced movement therapy (CIMT) within 4 months of study entry.&#xD;
             Participants should also refrain from receiving these treatments throughout the&#xD;
             duration of the study.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  The participant's forearm is too small to accommodate the standard FES electrodes.&#xD;
&#xD;
          -  The participant's muscles do not respond to the electrical stimulation as tested at&#xD;
             the baseline assessment visit. Response to electrical stimulation will be tested at&#xD;
             the baseline visit and is described in detail in the section entitled &quot;Muscle&#xD;
             Responsiveness Testing&quot; below. Based on the Muscle Responsiveness Testing procedures&#xD;
             and criteria, the withdrawal criteria for non-response to electrical stimulation is&#xD;
             defined as:&#xD;
&#xD;
               1. More than 3 muscle groups out of 11 not- responding to FES or&#xD;
&#xD;
               2. The participant reports a discomfort level score of 8 or 10 on the FACES scale&#xD;
                  (Appendix A) for any of the 11 muscle groups.&#xD;
&#xD;
          -  Participant receives any other active occupational therapy or hemiplegic hand&#xD;
             intervention during the FES intervention period.&#xD;
&#xD;
          -  Participant attends less than 36/48 FES intervention sessions.&#xD;
&#xD;
          -  Participant develops new-onset seizures during the FES intervention period.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>6 Years</minimum_age>
    <maximum_age>18 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Darcy Fehlings, MD, MSc</last_name>
    <role>Principal Investigator</role>
    <affiliation>Holland Bloorview Kids Rehabilitation Hospital</affiliation>
  </overall_official>
  <reference>
    <citation>Kapadia NM, Nagai MK, Zivanovic V, Bernstein J, Woodhouse J, Rumney P, Popovic MR. Functional electrical stimulation therapy for recovery of reaching and grasping in severe chronic pediatric stroke patients. J Child Neurol. 2014 Apr;29(4):493-9. doi: 10.1177/0883073813484088. Epub 2013 Apr 12.</citation>
    <PMID>23584687</PMID>
  </reference>
  <reference>
    <citation>Thrasher TA, Zivanovic V, McIlroy W, Popovic MR. Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. Neurorehabil Neural Repair. 2008 Nov-Dec;22(6):706-14. doi: 10.1177/1545968308317436.</citation>
    <PMID>18971385</PMID>
  </reference>
  <reference>
    <citation>Kawashima N, Popovic MR, Zivanovic V. Effect of intensive functional electrical stimulation therapy on upper-limb motor recovery after stroke: case study of a patient with chronic stroke. Physiother Can. 2013 Winter;65(1):20-8. doi: 10.3138/ptc.2011-36.</citation>
    <PMID>24381377</PMID>
  </reference>
  <reference>
    <citation>Sheffler LR, Chae J. Neuromuscular electrical stimulation in neurorehabilitation. Muscle Nerve. 2007 May;35(5):562-90. doi: 10.1002/mus.20758.</citation>
    <PMID>17299744</PMID>
  </reference>
  <reference>
    <citation>Quandt F, Hummel FC. The influence of functional electrical stimulation on hand motor recovery in stroke patients: a review. Exp Transl Stroke Med. 2014 Aug 21;6:9. doi: 10.1186/2040-7378-6-9. eCollection 2014.</citation>
    <PMID>25276333</PMID>
  </reference>
  <reference>
    <citation>Meadmore KL, Exell TA, Hallewell E, Hughes AM, Freeman CT, Kutlu M, Benson V, Rogers E, Burridge JH. The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study. J Neuroeng Rehabil. 2014 Jun 30;11:105. doi: 10.1186/1743-0003-11-105.</citation>
    <PMID>24981060</PMID>
  </reference>
  <reference>
    <citation>Golomb MR, Garg BP, Saha C, Azzouz F, Williams LS. Cerebral palsy after perinatal arterial ischemic stroke. J Child Neurol. 2008 Mar;23(3):279-86. doi: 10.1177/0883073807309246.</citation>
    <PMID>18305317</PMID>
  </reference>
  <reference>
    <citation>Prosser LA, Curatalo LA, Alter KE, Damiano DL. Acceptability and potential effectiveness of a foot drop stimulator in children and adolescents with cerebral palsy. Dev Med Child Neurol. 2012 Nov;54(11):1044-9. doi: 10.1111/j.1469-8749.2012.04401.x. Epub 2012 Aug 27.</citation>
    <PMID>22924431</PMID>
  </reference>
  <reference>
    <citation>Wright PA, Granat MH. Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy. Dev Med Child Neurol. 2000 Nov;42(11):724-7. doi: 10.1017/s0012162200001341.</citation>
    <PMID>11104342</PMID>
  </reference>
  <reference>
    <citation>Postans NJ, Granat MH. Effect of functional electrical stimulation, applied during walking, on gait in spastic cerebral palsy. Dev Med Child Neurol. 2005 Jan;47(1):46-52. doi: 10.1017/s0012162205000083.</citation>
    <PMID>15686289</PMID>
  </reference>
  <reference>
    <citation>Staudt M, Gerloff C, Grodd W, Holthausen H, Niemann G, Krageloh-Mann I. Reorganization in congenital hemiparesis acquired at different gestational ages. Ann Neurol. 2004 Dec;56(6):854-63. doi: 10.1002/ana.20297.</citation>
    <PMID>15562409</PMID>
  </reference>
  <verification_date>April 2016</verification_date>
  <study_first_submitted>April 25, 2016</study_first_submitted>
  <study_first_submitted_qc>January 9, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">January 11, 2017</study_first_posted>
  <last_update_submitted>February 22, 2018</last_update_submitted>
  <last_update_submitted_qc>February 22, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">February 26, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>cerebral palsy</keyword>
  <keyword>hemiplegia</keyword>
  <keyword>fes</keyword>
  <keyword>grasping</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Paralysis</mesh_term>
    <mesh_term>Cerebral Palsy</mesh_term>
    <mesh_term>Hemiplegia</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <pending_results>
    <submitted>February 16, 2021</submitted>
    <returned>March 10, 2021</returned>
    <submitted>March 19, 2021</submitted>
    <returned>April 14, 2021</returned>
  </pending_results>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03016923
org study id: 15-549
nct id: NCT03016923
lead sponsor: 
has dmc: No
The proposed pilot study seeks to explore the effectiveness of Functional Electrical
      Stimulation (FES) to improve upper limb function in children and youth (aged 6 to 18 years)
      with hemiplegic cerebral palsy, as measured by the QUEST grasp score and other secondary
      outcome measures obtained pre- and post-intervention in a case series study design.
Functional electrical stimulation (FES) has increasingly gained interest as a therapeutic
      intervention for the improvement of motor function in individuals with disabilities. FES
      involves the administration of electrical pulses to stimulate motor neurons and initiate
      muscle contractions, It has been used primarily for individuals with spinal cord injury or
      those who have experienced a stroke leading to the loss of or decreased motor function of the
      limbs. The repeated application of FES to the affected limb has been shown to enable
      individuals with hemiplegia to voluntarily control movements of the affected upper limb. A
      new FES system, has recently been developed and indicated for use for the improvement of arm
      and hand function in patients with hemiplegia due to stroke or spinal cord injury. FES is a
      non-invasive therapy that involves transcutaneous delivery of electrical stimulation to the
      affected upper limb, patient participation and the assistance of therapists to improve
      voluntary arm and hand movements such as reaching and grasping.

      The new FES system has shown effectiveness in both adults with acute stroke and children with
      chronic acquired stroke. In a randomized controlled trial, FES paired with intensive therapy
      compared to intensive therapy alone was shown to significantly improve hand function for
      adults with acute stroke. Participants in the trial had limited mobility or complete
      immobility of the affected arm and those who received FES paired with intensive therapy had
      clinically significant improvements in hand movements compared to those who only received
      intensive therapy. Recently, transcutaneous FES paired with intensive hand therapy (3
      one-hour sessions per week for 16 weeks) has more recently been shown to improve hand
      function in children with chronic acquired stroke.

      The efficacy of FES seen in patients with stroke opens up the possibility for its use in
      other similar populations, including children with hemiplegic cerebral palsy (HCP). However,
      there is currently limited research on the efficacy of FES with this population. In a
      preliminary study, the use of FES alone over a treatment period of 6 weeks in children with
      HCP was shown to significantly improve wrist movement. However, most of the research to date
      on the effects of FES on children with HCP has been focused on gait and lower limb function.
      There is currently a lack of evidence on the effectiveness of FES paired with intensive
      therapy on hand function in children with HCP. FES paired with intensive therapy holds
      significant potential to improve the hand function of children with HCP and warrants further
      investigation.

      Therefore, the proposed research seeks to address two main objectives:

        1. To investigate the effectiveness of FES to improve upper limb function in children with
           HCP.

        2. To assess the effects of FES on upper limb function in children with HCP at six months
           post-intervention.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Quality of Upper Extremities Skills Test (QUEST) as a measure of Movement patterns and hand function
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Canadian Occupational Performance Measure (COPM) as a measure of change in a child's self-perception of occupational performance over time
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Grip Strength Test as a measure of hand and forearm muscular strength
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Jebsen-Taylor Test of Hand Function (JTTHF) as a measure of hand functions required in activities of daily living
time frame: Change from Baseline (i.e., prior to intervention), at 4 months post-intervention, and at 6 months post-intervention. JTTHF will also be assessed at 4 weeks, 8 weeks, 12 weeks, and 16 weeks during the intervention period.
measure: Children's Hand-use Experience Questionnaire (CHEQ) as a measure of children's experience in using the affected hand in bi-manual activities
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Proprioception Task as a measure of joint-position sense
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Two-point Orientation Discrimination (2POD) as a measure of tactile spatial acuity
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
measure: Stereognosis Test as a measure of is the ability to recognize and identify common objects through tactile manipulation without the use of visual cues
time frame: Change from Baseline (i.e, prior to intervention), at 4 months post-intervention, and at 6 months post-intervention
arm group label: FES Therapy
arm group type: Experimental
description: FES therapy will be administered over the course of 1 hour sessions that will be take place 3 times per week over 16 weeks, for a total of 48 sessions.
intervention type: Device
intervention name: FES Therapy
description: FES therapy will be administered over the course of 1 hour sessions that will be take place 3 times per week over 16 weeks, for a total of 48 sessions.
arm group label: FES Therapy
criteria: 
gender: All
minimum age: 6 Years
maximum age: 18 Years
healthy volunteers: No
last name: Darcy Fehlings, MD, MSc
role: Principal Investigator
affiliation: Holland Bloorview Kids Rehabilitation Hospital
citation: Kapadia NM, Nagai MK, Zivanovic V, Bernstein J, Woodhouse J, Rumney P, Popovic MR. Functional electrical stimulation therapy for recovery of reaching and grasping in severe chronic pediatric stroke patients. J Child Neurol. 2014 Apr;29(4):493-9. doi: 10.1177/0883073813484088. Epub 2013 Apr 12.
PMID: 23584687
citation: Thrasher TA, Zivanovic V, McIlroy W, Popovic MR. Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. Neurorehabil Neural Repair. 2008 Nov-Dec;22(6):706-14. doi: 10.1177/1545968308317436.
PMID: 18971385
citation: Kawashima N, Popovic MR, Zivanovic V. Effect of intensive functional electrical stimulation therapy on upper-limb motor recovery after stroke: case study of a patient with chronic stroke. Physiother Can. 2013 Winter;65(1):20-8. doi: 10.3138/ptc.2011-36.
PMID: 24381377
citation: Sheffler LR, Chae J. Neuromuscular electrical stimulation in neurorehabilitation. Muscle Nerve. 2007 May;35(5):562-90. doi: 10.1002/mus.20758.
PMID: 17299744
citation: Quandt F, Hummel FC. The influence of functional electrical stimulation on hand motor recovery in stroke patients: a review. Exp Transl Stroke Med. 2014 Aug 21;6:9. doi: 10.1186/2040-7378-6-9. eCollection 2014.
PMID: 25276333
citation: Meadmore KL, Exell TA, Hallewell E, Hughes AM, Freeman CT, Kutlu M, Benson V, Rogers E, Burridge JH. The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study. J Neuroeng Rehabil. 2014 Jun 30;11:105. doi: 10.1186/1743-0003-11-105.
PMID: 24981060
citation: Golomb MR, Garg BP, Saha C, Azzouz F, Williams LS. Cerebral palsy after perinatal arterial ischemic stroke. J Child Neurol. 2008 Mar;23(3):279-86. doi: 10.1177/0883073807309246.
PMID: 18305317
citation: Prosser LA, Curatalo LA, Alter KE, Damiano DL. Acceptability and potential effectiveness of a foot drop stimulator in children and adolescents with cerebral palsy. Dev Med Child Neurol. 2012 Nov;54(11):1044-9. doi: 10.1111/j.1469-8749.2012.04401.x. Epub 2012 Aug 27.
PMID: 22924431
citation: Wright PA, Granat MH. Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy. Dev Med Child Neurol. 2000 Nov;42(11):724-7. doi: 10.1017/s0012162200001341.
PMID: 11104342
citation: Postans NJ, Granat MH. Effect of functional electrical stimulation, applied during walking, on gait in spastic cerebral palsy. Dev Med Child Neurol. 2005 Jan;47(1):46-52. doi: 10.1017/s0012162205000083.
PMID: 15686289
citation: Staudt M, Gerloff C, Grodd W, Holthausen H, Niemann G, Krageloh-Mann I. Reorganization in congenital hemiparesis acquired at different gestational ages. Ann Neurol. 2004 Dec;56(6):854-63. doi: 10.1002/ana.20297.
PMID: 15562409
responsible party type: Sponsor
mesh term: Paralysis
mesh term: Cerebral Palsy
mesh term: Hemiplegia
sharing ipd: No
submitted: February 16, 2021
returned: March 10, 2021
submitted: March 19, 2021
returned: April 14, 2021