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Trial registered on ANZCTR
Registration number
ACTRN12607000484448
Ethics application status
Approved
Date submitted
6/09/2007
Date registered
21/09/2007
Date last updated
21/09/2007
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of botulinum toxin-A on the functional ability of the very young child with spastic hemiplegia due to cerebral palsy.
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Scientific title
A randomised controlled trial to determine the effects of botulinum toxin-A on the functional ability of the very young child with spastic hemiplegia due to cerebral palsy.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
spasticity in children with cerebral palsy
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Condition category
Condition code
Neurological
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
botulinum toxin-A (BOTOX) to treat spastic equinus by intramuscular injection; 6-12 U/kgtotal body weight; repeat injections at no less than six monthly intervals beginning at the motor stage of "pull to stand"
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Standard best practice treatment: Botulinum toxin -A (BOTOX) to treat spastic equinus by intramuscular injection; 6-12 U/kgtotal body weight; repeat injections at no less than six monthly intervals beginning after two years of age AND when ambulant
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Control group
Active
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Outcomes
Primary outcome [1]
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quality of gait measured by Physicians Rating Scale (PRS), Toddler and Infant Motor Evaluation (TIME) and Gross Motor Performance Measure (GMPM)
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Assessment method [1]
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Timepoint [1]
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3 monthly from time of independent walking until three years of age
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Primary outcome [2]
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amount of dynamic calf muscle spasticity measured by Modified Tardieu Scale(MTS) and Modifie4d Ashworth Score (MAS)
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Assessment method [2]
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Timepoint [2]
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at 0, 1, 3, 6, 7, 9, 12, 13, 15, 18, 19, 21, 24, 25, 17, 30, 31 months
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Primary outcome [3]
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gross motor function as measured by the Gross Motor Function Measure (GMFM), and the Toddler and Infant Motor Evaluation (TIME)
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Assessment method [3]
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Timepoint [3]
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0, 6, 12, 18, 24 months after motor stage of "pull to stand"
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Secondary outcome [1]
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upper limb function measured by Assisting Hand Assessment (AHA)
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Assessment method [1]
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Timepoint [1]
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at 3 years of age
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Eligibility
Key inclusion criteria
spastic hemiplegia due to CP
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Minimum age
9
Months
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Maximum age
22
Months
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
already independently ambulating;
concurrent unrelated disability or serious long term illness
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
concealed allocation by numbered containers
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
a form of dynamic, block randomisation (minimisation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/10/2002
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Allergan Australia Pty Ltd
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Address [1]
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NSW
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Sarah Love
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Address
Physiotherapy Department
Princess Margaret Hospital
GPO Box D184 PERTH WA 6840
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Princess Margaret Hospital
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Address [1]
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GPO Box D184 PERTH WA 6840
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Country [1]
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Australia
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Other collaborator category [1]
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University
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Name [1]
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Curti University of Technology
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Address [1]
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GPO Box U1987
PERTH WA 6840
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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AProf Eve Blair
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Address [2]
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ICHR
Roberts Road Subiaco WA6008
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Prof Joan Cole
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Address [3]
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c/Physio department
Princess Margaret Hospital
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Country [3]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Curtin University HREC
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Ethics committee address [1]
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as above
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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10/03/2002
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Ethics approval number [1]
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CUT HR 9/2002
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Ethics committee name [2]
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Womens and Children's Health Service HREC
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Ethics committee address [2]
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Princess Margaret Hospital
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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Approval date [2]
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10/03/2002
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Ethics approval number [2]
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PMH 633/ep
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Summary
Brief summary
Cerebral palsy (CP) is a disorder affecting around 2.5 in 1000 live births. Commonly, children with CP have spasticity in their muscles causing stiffness. Children with spasticity move differently because of this stiffness. When botulinum toxin-A (BOTOX) is injected into a spastic muscle, it helps relax the muscle for around three months, after which the effect begins to wear off. During this time, the muscle is able to move more freely through a greater range, allowing the child to use more normal patterns of muscle recruitment. BOTOX is recommended and PBS rebatable for children with CP who are over two years of age and who are ambulant. Usually, by two years of age these children have developed an abnormal pattern of movement, especially around the ankle. Currently, the most important clinical question is whether BOTOX should be used to prevent this early imperfect standing and walking practice rather than be used after two years of age to correct the problem that has developed. Injections of BOTOX at a younger age may provide the child with an early sensation of more normal movement and lay down patterns of movement that will be useful in the long term. The aim of this study is to compare, over a three year period, the effects of early (beginning at the motor stage of "pull-to-stand") repeated BOTOX injections on gross motor function and the development of walking with the effects of later ( beginning after two years of age) standard repeated BOTOX treatment. The main measures will be the gross motor function measures and quality of walking. Measurements (such as muscle spasticity, muscle length, parent questionnaires and functional ability of the upper limb) will also be made to determine which program most positively affects walking, other gross motor functions and /or quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Sarah Love
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Address
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Physiotherapy Department
Princess Margaret Hospital
Roberts Road Subiaco 6008 WA
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Country
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Australia
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Phone
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+61 8 9340 8503
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Fax
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+61 8 9340 8597
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Email
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[email protected]
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Contact person for scientific queries
Name
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Sarah Love
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Address
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Physiotherapy Department
Princess Margaret Hospital
Roberts Road Subiaco 6008 WA
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Country
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Australia
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Phone
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+61 8 9340 8503
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Fax
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+61 8 9340 8597
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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