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The role of foot orthoses in children with developmental coordination disorder
ISRCTN ISRCTN59547425
ClinicalTrials.gov identifier
Public title The role of foot orthoses in children with developmental coordination disorder
Scientific title A pilot study to evaluate the benefit of foot orthoses prescribed in the rehabilitation of children with developmental coordination disorder
Acronym N/A
Serial number at source N/A
Study hypothesis Developmental coordination disorder (DCD) is a defined as a "motor skill disorder characterised by a marked impairment in the development of motor coordination abilities" (American Psychiatric Association, 2004) and such a condition will affect the execution of everyday tasks. Characteristics of DCD noted within the literature include poor balance, delayed developmental characteristics and a "clumsy" and "awkward" gait (Polatajko and Cantin, 2006). DCD is reported to have an impact upon both fine and gross motor skills which results in limited participation in everyday activities of childhood (Polatajko and Cantin, 2006). Further impact of DCD has been reported as limited academic achievement, reduced participation in sport and implications for psycho-social development; particularly with regards to limited interaction with peers. (Polatajko and Cantin, 2006).

Hypotheses:
1. Do University of California Biomechanics Laboratory (UCBL) foot orthoses improve balance and reduce tripping in children with DCD?
2. Do UCBL foot orthoses normalise the spatial and temporal gait parameters in children with DCD?
Ethics approval Ethics approval received from Lewisham LREC on the 11th June 2008 (ref: 08/H0810/38).
Study design Randomised controlled trial. The children will be quasi-randomised into two groups.
Countries of recruitment United Kingdom
Disease/condition/study domain Developmental coordination disorder (DCD)
Participants - inclusion criteria The study population will be composed of children entering the multi-disciplinary therapy programme at the Sanderson Child Development Centre, Medway Maritime Hospital. Children entering this programme:
1. Have an established diagnosis of DCD
2. Will be aged 7 years and over
Participants - exclusion criteria 1. Any relevant medical complications that are likely to prevent a change in gait parameters. This includes any condition affecting neuromuscular integrity and orthopaedic condition causing a gait disturbance.
2. Unwilling to wear footwear that is suitable to use with an orthoses (low heeled, fastening, supportive footwear)
Anticipated start date 01/06/2008
Anticipated end date 31/05/2010
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 30
Interventions UCBL foot orthoses are being used in the study. The effect of the foot orthoses in the management of DCD diagnosed children will be determined by comparing the two groups of children:
1. One group of children will be prescribed their orthoses at the start of the seven week rehabilitation programme
2. One group of children will be prescribed their orthoses at the end of the seven week programme

This will allow all children who would normally be prescribed orthoses to receive orthoses - no children will be prevented from receiving the treatment that they would normally have because they are participating in the study.

The intervention will be assessed over a period of seven weeks; once at the start of the seven week programme and once at the end. These foot orthoses currently form part of the multi-disciplinary management of children with DCD therefore, the duration will be as long as the subject requires them.
Primary outcome measure(s) The GAITRite Gold Footmat will be used in the study to identify spatio-temporal gait parameters. This is a walkway which is embedded with sensors. The GAITRite system can provide measurements of spatial parameters such as step length, stride length, base of gait, angle of progression; it can provide measurements of temporal parameters such as cadence, velocity, stance phase duration, swing phase duration. Previous studies have identified the following parameters as being changed in children with DCD:
1. Single support duration (decreased)
2. Swing phase (decreased)
3. Cadence (increased)
4. Stride length (decreased)

These parameters will be used as primary outcome measures and recorded pre- and post-provision of foot orthoses, assessed at the start and end of the seven week programme.
Secondary outcome measure(s) The Bruininks-Oseretsky test of motor proficiency (BOT) is a tool that measures improvement in function in children using an individually administered measure of gross and fine motor skills. The score consists of eight subtests which assess:
1. Fine motor precision: seven items (e.g., cutting out a circle, connecting dots)
2. Fine motor integration: eight items (e.g., copying a star, copying a square)
3. Manual dexterity: five items (e.g., transferring pennies, sorting cards, stringing blocks)
4. Bilateral coordination: seven items (e.g., tapping foot and finger, jumping jacks)
5. Balance: nine items (e.g., walking forward on a line, standing on one leg on a balance beam)
6. Running speed and agility: five items (e.g., shuttle run, one-legged side hop)
7. Upper-limb coordination: seven items (e.g., throwing a ball at a target, catching a tossed ball)
8. Strength: five items (e.g., standing long jump, sit-ups)

The data taken from BOT composite scores will be used in secondary analysis. This will include body coordination, strength and agility and total motor composite scores. Secondary outcome measures will be assessed at the start and end of the seven week programme.
Sources of funding Canonbury Products Ltd (UK) - supported with a £5000 research prize
Trial website
Publications
Contact name Dr  Stewart  Morrison
  Address School of Health and Bioscience
Romford Road
University of East London
  City/town London
  Zip/Postcode E15 4LZ
  Country United Kingdom
Sponsor Canonbury Products Ltd (UK)
  Address 2 St James Road
  City/town Brackley, Northamptonshire
  Zip/Postcode NN13 7XY
  Country United Kingdom
  Sponsor website: http://www.canonbury.com/epages/canonbury.storefront
Date applied 13/02/2008
Last edited 11/09/2008
Date ISRCTN assigned 04/03/2008
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