Operant Conditioning of the Soleus Stretch Reflex in Adults With Cerebral Palsy

What this Trial Is About

Researchers are evaluating a novel intervention called operant conditioning of the soleus H reflex in adults with spastic cerebral palsy (CP). Spasticity in CP causes significant challenges due to increased muscle tone and activity restrictions, resulting from upper motor neuron injury and disrupted motor tone control. This study aims to reduce spasticity through a non-invasive technique that has shown promising effects in other neurological conditions, potentially offering a new or supplementary treatment approach for people with CP. Participants will undergo 6 baseline sessions followed by 24 conditioning sessions held three times per week. During each session, electrical pulses will be applied to the tibial nerve to elicit the soleus H reflex while participants stand comfortably. They will complete trials without and with visual feedback to learn how to reduce the reflex magnitude in their calf muscle on the more-affected leg. The intervention is behavioral and non-invasive, focusing on training participants to decrease their reflex activity. Throughout the study, clinical and physiological assessments collected at baseline will be repeated after the intervention and during follow-ups at 2 weeks, 1 month, and 3 months. Outcome measures include soleus H-reflex size, walking tests, motor function scales, balance and mobility tests, and various patient-reported outcome measures related to anxiety, fatigue, depression, physical function, and social participation. Researchers will also monitor session attendance and evaluate changes in motor evoked potentials and hand function. The study duration covers the baseline, intervention, and follow-up periods to assess both immediate and retained effects.

Operant Conditioning of the Soleus Stretch Reflex in Adults With Cerebral Palsy