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Trial registered on ANZCTR
Registration number
ACTRN12609000912280
Ethics application status
Approved
Date submitted
16/10/2009
Date registered
21/10/2009
Date last updated
1/09/2024
Date data sharing statement initially provided
1/09/2024
Date results provided
1/09/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
INCITE - a randomised trial of Novel upper limb rehabilitation in congenital hemiplegia
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Scientific title
"A Randomised Trial Comparing Constraint Induced Movement Therapy and Bimanual Training on Upper Limb Function in Patients with Congenital Hemiplegia ".
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Secondary ID [1]
1117
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Nationa Health and Medical Research Council (NHMRC) 368500
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Universal Trial Number (UTN)
Nil
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Trial acronym
INCITE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Congenital Hemiplegia
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Cerebral Palsy
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Condition category
Condition code
Neurological
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0
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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
Constraint Induced movement therapy involves use of tailor made glove like splint worn on the unimpaired (dominant writting hand) and intensive activity based practice activities encouraging active use and manipulation with the other impaired (hemiplegic hand). Participants in the CIMT group will wear a tailor made glove on their unimpaired limb while attending the day camp, which will only be removed for toileting. The training occurs for 6 hours per day over 10 days for a total dose of 60 hours, with one trainer per two participants, in a comunity recreation facility.
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Intervention code [1]
241421
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Rehabilitation
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Comparator / control treatment
Bimanual Training involves atcivity based practice with tasks that focus on equal use of both hands (both the unimpaired and the hemiplegic hand) in the task. The training occurs for 6 hours per day over 10 days for a total dose of 60 hours, with one trainer per two participants, in a comunity recreation facility.
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Control group
Active
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Outcomes
Primary outcome [1]
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Unimanual capacity for the hemiplegic limb measured on the Melbourne Unilateral Upper Limb Assessment
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Assessment method [1]
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Timepoint [1]
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at 26 weeks post intervention
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Secondary outcome [1]
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Bimanual Co-ordination on the Assisting Hand Assessment (AHA)
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Assessment method [1]
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Timepoint [1]
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at 26 weeks post
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Secondary outcome [2]
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Neuroplasticity determined on the Motor Evoked Potential (MEP) curves using Transcranial Magnetic Stimulation (TMS)
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Assessment method [2]
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Timepoint [2]
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at 26 weeks post intervention
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Secondary outcome [3]
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Community participation across borad domians on the Life Habits Questionnaire.
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Assessment method [3]
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Timepoint [3]
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at 26 weeks post intervention
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Secondary outcome [4]
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Quality of Life on the Cerebral Palsy Quality of Life Quesstionnaire (the CPQOL-Child Questionnaire).
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Assessment method [4]
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Timepoint [4]
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at 26 weeks post intervetnion
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Secondary outcome [5]
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Neurovascular changes in the primary motor cortex
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Assessment method [5]
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Timepoint [5]
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at 26 weeks post intervention
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Eligibility
Key inclusion criteria
Inclusion criteria
The study will include children and youth:
1. With a confirmed diagnosis of congenital hemiplegia.
2. Aged 5 to 16 years.
3. With predominant spasticity rather than dystonia interfering with upper limb function according to the classification of motor type by Sanger et al[31] with Modified Ashworth Scale grade >1 but <3.[32]
4. Ability to achieve minimal active grasp with the impaired hand.
5. Sufficient co-operation and cognitive understanding to participate in the group activities.
For a subset of children performing the Advanced Brain Imaging and Transcranial Magnetic Stimulation (TMS) studies further inclusion criteria are:-
1. Sufficient co-operation to perform Advanced Brain Imaging studies for 45 minutes.
2. No exclusions for 3 tesla Magnetic Resonance Imaging (3T MRI) including no metal implants, no shunts, no uncontrolled epilepsy as the later would be a confound.
3. For TMS there must be no current or previous history of epilepsy.
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Minimum age
5
Years
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Maximum age
16
Years
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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
1. Severe muscle spasticity and/or contracture on the Modified Ashworth Scale(MAS > grade 3, i.e. muscle contracture or rigidity) which would require spasticity management or serial casting.
2. Previous orthopaedic surgery in the upper limb.
3. Serial casting or Botulinum Toxin A (BoNT-A) injections in the upper limb within 6 months prior to study entry.
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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)
Children will be matched in pairs according to age (12 month age bands), gender, side of hemiplegia, and level of functional ability based on Melbourne Unilateral Upper limb Assessment (MUUL) scores at screening. Once matching has been achieved and baseline assessments completed, children will be randomised within pairs from concealed envelopes opened by non-study personnel. Treatment allocation will be recorded on a piece of folded paper inside each envelope in random order (computer generated). The randomisation process will involve allocating a number “1” or “2’ to each member of the pair which will be written on the paper inside the envelope. As each pair is entered, they will be allocated the next consecutive envelope, which will be opened by the non-study personnel who will read and record the treatment allocation from the paper inside the envelope. Study personnel will be informed of group allocation.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
randomisation within pairs by computer number generation of 0 or 1 alternatives within the pairs
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2007
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Actual
1/06/2007
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Date of last participant enrolment
Anticipated
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Actual
1/06/2010
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Date of last data collection
Anticipated
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Actual
9/07/2010
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Sample size
Target
52
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Accrual to date
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Final
64
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Recruitment in Australia
Recruitment state(s)
QLD,VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Institute
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
National Health and Medical Research Insitute
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Address
National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Royal Childrens Hospital Foundation
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Address [1]
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Royal Childrens Hospital Foundation,
Royal Childrens Hospital,
Herston rd.,
Herston. 4006
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Country [1]
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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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Royal Children?s Hospital and Health Services District
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Ethics committee address [1]
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Department of Pediatrics and Child Health 3rd Floor, Foundation Building, Royal Childrens Hospital, Herston Rd., Herston. 4072
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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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31/05/2008
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Approval date [1]
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01/07/2008
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Ethics approval number [1]
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HREC 2008/018
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Ethics committee name [2]
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Royal Childrens Hospital, Melbourne
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Ethics committee address [2]
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Ethics in Human Research Committee, Ground Floor, Royal Childrens Hospital, Flemington Rd., Parkville. 3053 Victoria
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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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01/02/2007
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Approval date [2]
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01/03/2007
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Ethics approval number [2]
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HREC 26074 A,B,C,D
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Ethics committee name [3]
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University of Queensland
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Ethics committee address [3]
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Medical Ethics Committee, University of Queensland, Research and Graduate Studies Office, St Lucia, 4072.
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
244007
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01/07/2008
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Approval date [3]
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01/08/2008
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Ethics approval number [3]
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2008000961
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Summary
Brief summary
This randomsied comparison trial will test the efficiacy of a novel rehabilitation (constraint induced movement therapy) whcih involves placing a glove on the unimpaired hand and intensively training the Hemiplegic hand and comparing this approach to more conventional bimanaul training in children with congenital hemiplegia.
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Trial website
nil
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Trial related presentations / publications
3. Gilmore R., Ziviani J, Sakzewski L., Boyd RN. A Clinimetric Review of Upper limb activity limitation measures. Developmental Medicine & Child Neurology. Accepted April 2009. (IF 2.433) 4. Sakzewski L, Ziviani J, Boyd RN. Efficacy of Non surgical interventions for congenital hemiplegia- Met analysis. Pediatrics, Accepted 30th Jan 2009. (IF= 4.473)
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Public notes
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Contacts
Principal investigator
Name
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Prof Roslyn Boyd
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Address
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Queensland Cerebral Palsy and Rehabilitation Research Centre
Child Health Research Centre
The University of Queensland
Centre for Children’s Health Research
Room 611, Level 6, 62 Graham Street
South Brisbane QLD 4101 Australia
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Country
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Australia
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Phone
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+61 7 30697372
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Fax
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+61 7 30697109
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Email
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[email protected]
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Contact person for public queries
Name
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Roslyn Boyd
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Address
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Queensland Cerebral Palsy and Rehabilitation Research Centre
Child Health Research Centre
The University of Queensland
Centre for Children’s Health Research
Room 611, Level 6, 62 Graham Street
South Brisbane QLD 4101 Australia
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Country
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Australia
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Phone
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+61 7 30697372
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Fax
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+61 7 30697109
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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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Roslyn Boyd
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Address
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Queensland Cerebral Palsy and Rehabilitation Research Centre
Child Health Research Centre
The University of Queensland
Centre for Children’s Health Research
Room 611, Level 6, 62 Graham Street
South Brisbane QLD 4101 Australia
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Country
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Australia
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Phone
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+61 7 30697372
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Fax
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+61 7 30697109
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Email
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[email protected]
;
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Data sharing will follow the UQ Guidelines. Only deidentified data and outcomes will be shared.
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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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