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Clinical effectiveness of a child-specific dynamic stretching programme, compared to usual care, for ambulant children with spastic cerebral palsy (SPELL trial): a parallel group randomized controlled trial.

dc.contributor.authorTheologis, Tim
dc.contributor.authorPerry, Daniel C
dc.contributor.authorRombach, Ines
dc.contributor.authorKeene, David J
dc.contributor.authorMarian, Ioana R
dc.contributor.authorAndrew, Morag
dc.contributor.authorBarry, Catherine
dc.contributor.authorDavis, Loretta
dc.contributor.authorFirth, Gregory
dc.contributor.authorFletcher, Heidi
dc.contributor.authorFordham, Beth
dc.contributor.authorGregory Osborne, Vivi
dc.contributor.authorGregory Osborne, Helen
dc.contributor.authorKatchburian, Lesley
dc.contributor.authorO'Mahoney, Joanna
dc.contributor.authorParr, Jeremy R
dc.contributor.authorRapson, Rachel
dc.contributor.authorRyan, Jennifer
dc.contributor.authorEr, Fema
dc.contributor.authorStone, Megan
dc.contributor.authorWood, Helen
dc.contributor.authorHopewell, Sally
dc.date.accessioned2025-06-10T08:27:24Z
dc.date.available2025-06-10T08:27:24Z
dc.date.issued2025-05-01
dc.identifier.citationTheologis, T., Perry, D. C., Rombach, I., Keene, D. J., Marian, I. R., Andrew, M., Barry, C., Davis, L., Firth, G., Fletcher, H., Fordham, B., Gregory Osborne, V., Gregory Osborne, H., Katchburian, L., O'Mahoney, J., Parr, J. R., Rapson, R., Ryan, J., Er, F., Stone, M., … Hopewell, S. (2025). Clinical effectiveness of a child-specific dynamic stretching programme, compared to usual care, for ambulant children with spastic cerebral palsy (SPELL trial): a parallel group randomized controlled trial. Bone & joint open, 6(5), 506–516. https://doi.org/10.1302/2633-1462.65.BJO-2024-0267en_US
dc.identifier.pmid40306688
dc.identifier.pmidPMC12043370
dc.identifier.doi10.1302/2633-1462.65.BJO-2024-0267
dc.identifier.urihttp://hdl.handle.net/10147/645244
dc.descriptionAims Dynamic muscle stretching exercises are one of the interventions frequently prescribed by physiotherapists for children with cerebral palsy (CP). However, there is wide variability in the exercise regimes used and limited evidence of their effectiveness. The SPELL trial will assess the clinical effectiveness of an individually tailored dynamic stretching programme, compared to usual care for ambulant children with spastic CP. Methods We are conducting a multicentre, two-arm, parallel group, superiority randomized controlled trial. We will recruit children aged four to 11 years with a diagnosis of spastic CP (bilateral or unilateral) and Gross Motor Function Classification System (GMFCS) levels I to III who are able to comply with assessment procedures and exercise programme with or without support. Participants will be recruited from at least 12 UK NHS Trust physiotherapy and related services. Participants (n = 334) will be randomized (centralized computer-generated one:one allocation ratio) to either: 1) a dynamic stretching exercise programme, with six one-to-one physiotherapy sessions over 16 weeks; or 2) usual NHS care, with a single physiotherapy session and an assessment, and advice regarding self-management and exercise. Conclusion The primary outcome is functional mobility measured using the child-/parent-reported Gait Outcomes Assessment List (GOAL) at six months. Secondary outcomes are: joint range of motion (Cerebral Palsy Integrated Pathway protocol) and motor function (timed up and go test) at six months; functional mobility (GOAL) at 12 months; independence (GOAL subdomain A); balance (GOAL subdomain A, B, D); pain and discomfort (GOAL subdomain C); health-related quality of life (youth version of the EuroQol five-dimension questionnaire (EQ-5D-Y)); educational attendance; exercise adherence; and additional physiotherapy treatment at six and 12 months. The primary analysis will be intention to treat.en_US
dc.language.isoenen_US
dc.rights© 2025 Theologis et al.
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleClinical effectiveness of a child-specific dynamic stretching programme, compared to usual care, for ambulant children with spastic cerebral palsy (SPELL trial): a parallel group randomized controlled trial.en_US
dc.typeArticleen_US
dc.identifier.eissn2633-1462
dc.identifier.journalBone & joint openen_US
dc.source.journaltitleBone & joint open
dc.source.volume6
dc.source.issue5
dc.source.beginpage506
dc.source.endpage516
refterms.dateFOA2025-06-10T08:27:27Z
dc.source.countryEngland


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