RecruitingInterventional

Dynamic stretching programme for children with cerebral palsy

Cerebral palsy can cause stiff, tight muscles, making everyday movement and walking difficult for children. Physiotherapy exercises are a key part of daily life to help muscles stay flexible and support active play. However, physiotherapists currently use many different stretching routines, and there is little clear evidence showing which ones work best. The SPELL trial is testing a specific dynamic stretching programme against standard NHS physiotherapy care. The study is open to children aged 4 to 11 with spastic cerebral palsy. Half of the children will take part in six physiotherapy sessions over 16 weeks to learn dynamic stretches. The other half will receive standard NHS physiotherapy advice in one session. Both groups will have check-ups and complete questionnaires over 12 months to see how they get on. The findings will help shape future NHS care for children with cerebral palsy.

At a glance

Status

Recruiting

Sponsor

University of Oxford

Enrolment target

334

Start

28 Nov 2023

Estimated completion

31 Dec 2026

Cerebral palsy

What is this study about?

Cerebral palsy is a condition that affects movement and co-ordination. It happens when a baby's brain is injured around the time of birth, often due to a lack of oxygen. Many children with cerebral palsy experience muscle stiffness, also known as spasticity. This stiffness can make walking, running, and joining in everyday games or school activities challenging. Regular physiotherapy exercises help keep muscles loose, maintain flexibility, and support children in staying active.

Stretching tight muscles is one of the most common treatments used by physiotherapists. Even so, there is no single agreed way to do these exercises, and routines vary widely across the UK. Because of this, healthcare experts have called for clearer evidence to show which exercise programmes actually make the biggest difference to a child's day-to-day mobility.

The SPELL trial aims to answer this question. By comparing a structured dynamic stretching programme directly with standard NHS physiotherapy advice, the research team hopes to learn which method is more effective. The results will help physiotherapists across the country offer the best possible care to children living with cerebral palsy.

Key takeaways

Tests whether dynamic stretching works better than standard NHS physiotherapy advice for children with cerebral palsy.
Open to children aged 4 to 11 with spastic cerebral palsy who can walk with or without aids.
Involves either 6 physiotherapy sessions over 16 weeks or a single advice session, chosen at random.
Includes physical check-ups and parent questionnaires over a 12-month period.
No medicines are involved, and participation is completely voluntary.

Who may be eligible?

This study is designed for children aged between 4 and 11 years who have been diagnosed with spastic cerebral palsy. To be eligible, the child should be able to walk, either on their own or with the help of walking aids (known medically as GMFCS levels I to III). Families must also be happy for their local community physiotherapy team and GP to be told about their participation.

Children cannot take part if they have had surgery on their legs, or a nerve operation called selective dorsal rhizotomy, in the past 12 months, or if they have surgery planned within the next 6 months. Children who have had botulinum toxin (Botox) injections in their legs or plaster casting within the last 4 months (or planned in the next 6 months) are also unable to join.

Finally, children who are already doing a regular dynamic stretching programme as part of their routine care, or who would struggle to complete the exercises and study assessments even with support from a parent or guardian, will not be able to participate.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

My child is aged between 4 and 11 years old.
My child has a diagnosis of spastic cerebral palsy.
My child can walk, either independently or using walking aids.
My child has not had leg surgery or SDR in the past year (and none is planned in the next 6 months).
My child has not had Botox injections or leg casts in the past 4 months (and none are planned in the next 6 months).
My child is not already following a regular dynamic stretching routine.

Answer every question to see your result.

What does participation involve?

Taking part in the study lasts for 12 months. After joining, children are randomly placed into one of two groups by a computer, like tossing a coin. Neither families nor doctors can choose the group.

Children in the exercise group will attend six sessions with a physiotherapist spread over 16 weeks. During these visits, they will learn and practice specific dynamic muscle stretches to do at home. Children in the usual care group will have one session with a physiotherapist to receive standard guidance and advice on their normal exercises, without the dynamic stretching routine. No new medicines are used in this study.

Both groups will have a physical check-up with a researcher at the start of the study and again after 6 months. Parents or guardians will also be asked to fill out short questionnaires about their child's health and daily activities at the start, at 6 months, and at 12 months.

Potential risks and benefits

Taking part may not directly benefit your child, but the findings could help improve NHS physiotherapy for many other children with cerebral palsy in the future. As with any new physical activity, the exercises may cause mild muscle soreness or temporary limping for a few days afterwards. A physiotherapist will guide the exercises carefully to keep your child comfortable. Taking part is entirely voluntary, and you are free to leave the study at any time without your child's standard NHS care being affected.

Locations (33)

University Hospitals Dorset NHS Foundation Trust
City only
Poole, England
Derbyshire Healthcare NHS Foundation Trust
Approximate
Derby, England
Gloucestershire Health and Care NHS Foundation Trust
City only
Gloucester, England
Alder Hey Children's NHS Foundation Trust
City only
Liverpool, England
Solent NHS Trust
City only
Southampton, England
Isle of Wight NHS - Hq
Unverified
Newport, England
Barts Health NHS Trust
Unverified
London, England
Coventry and Warwickshire Partnership NHS Trust
Unverified
Coventry, England
St George's University Hospitals NHS Foundation Trust
Unverified
London, England
Leeds Community Healthcare NHS Trust
Unverified
Leeds, England
West Suffolk NHS Foundation Trust
Unverified
Bury St. Edmunds, England
The Royal Wolverhampton NHS Trust
Unverified
Wolverhampton, England

Common questions

What is dynamic stretching?

Dynamic stretching involves moving muscles and joints gently through their full range of movement, rather than holding a stretch completely still.

Will my child have to take any medicines?

No. The study focuses purely on physiotherapy exercises and does not involve any drugs or injections.

Can we choose which group my child goes into?

No. A computer randomly assigns each child to either the dynamic stretching group or the standard care group so the results are fair and reliable.

What if an exercise makes my child uncomfortable?

Mild muscle soreness can happen after new exercises, but the physiotherapist can adjust the movements to ensure your child remains comfortable and safe.

What happens if we decide to stop taking part?

You can leave the study at any point without giving a reason. Your child will continue to receive their standard NHS healthcare and physiotherapy as usual.

How to find out more

Miriam Tillmann-Morris

miriam.tillmann-morris@ndorms.ox.ac.uk +44 (0)1865 613763 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.