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Trial registered on ANZCTR
Registration number
ACTRN12618000985280
Ethics application status
Approved
Date submitted
1/06/2018
Date registered
12/06/2018
Date last updated
7/08/2020
Date data sharing statement initially provided
14/05/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Understanding outcomes for Australian children undergoing Selective Dorsal Rhizotomy
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Scientific title
Australian Children undergoing Selective Dorsal Rhizotomy - a national registry of multidimensional outcomes pertaining to the International Classification of Functioning, Disability and Health.
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Secondary ID [1]
294972
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National Registry for Selective Dorsal Rhizotomy in Australia: PG1616
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Universal Trial Number (UTN)
U1111-1214-5384
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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:
Cerebral Palsy
307971
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Condition category
Condition code
Neurological
307011
307011
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0
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Other neurological disorders
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Physical Medicine / Rehabilitation
307151
307151
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
10
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Target follow-up type
Years
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Description of intervention(s) / exposure
The Australian SDR Research Registry is a 10 year longitudinal cohort study of children with cerebral palsy who have had or will have the Selective Dorsal Rhizotomy procedure in an Australian centre or overseas centre. Data collected will include surgery and admission details, surgical and long term adverse events, and outcome measures across the body structure and function, activity and participation domains of the International Classification of Functioning, Disability and Health (ICF). Data will be collected at baseline, during inpatient admission and at one, two, five and ten years post intervention. The objective of collecting this data is to improve understanding of the short, medium and long term outcomes and any adverse effects of the intervention thereby providing clinicians with information to guide families considering this neurosurgical intervention..
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Intervention code [1]
301295
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
305993
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Change in Gross Motor Function Measure - 66 (GMFM-66) scores
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Assessment method [1]
305993
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Timepoint [1]
305993
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Baseline, and at 1, 2, 5 and 10 years after selective dorsal rhizotomy surgery
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Secondary outcome [1]
347232
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Functional mobility assessed using the Functional Mobility Scale
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Assessment method [1]
347232
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Timepoint [1]
347232
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [2]
347235
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Gait assessed using the Gait Profile Score and the Gait Variable Scores from 3-Dimensional Gait Analysis
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Assessment method [2]
347235
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Timepoint [2]
347235
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [3]
347241
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Goal attainment assessed using the Canadian Occupational Performance Measure
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Assessment method [3]
347241
0
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Timepoint [3]
347241
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Baseline and at 1 and 2 years post Selective Dorsal Rhizotomy
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Secondary outcome [4]
347243
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Pain assessed using the Faces Pain Scale-Revised, checklist of pain location and PROMIS Pediatric Pain Interference Scale
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Assessment method [4]
347243
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Timepoint [4]
347243
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Baseline, and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy
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Secondary outcome [5]
347244
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Quality of life assessed using the Cerebral Palsy Quality of Life Questionnaire (proxy report)
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Assessment method [5]
347244
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Timepoint [5]
347244
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [6]
347247
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Surgical adverse events using the Clavien-Dindo classification
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Assessment method [6]
347247
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Timepoint [6]
347247
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At time of surgery and during inpatient stay
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Secondary outcome [7]
347748
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Gross motor function assessed using the the Gillette Functional Assessment Questionnaire
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Assessment method [7]
347748
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Timepoint [7]
347748
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [8]
347749
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Functional mobility assessed using the 6 minute walk test
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Assessment method [8]
347749
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Timepoint [8]
347749
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [9]
347750
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Mobility assessed using the Timed up-and-go test
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Assessment method [9]
347750
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Timepoint [9]
347750
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [10]
347792
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Long term adverse event of spinal deformity assessed using spine radiograph.
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Assessment method [10]
347792
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Timepoint [10]
347792
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [11]
347793
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Long term adverse event of hip subluxation assessed by measuring hip migration percentages with pelvis radiograph.
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Assessment method [11]
347793
0
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Timepoint [11]
347793
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [12]
347794
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Long term adverse event of foot deformity assessed from clinical examination in standing, and/or with assistance of a frontal (PA) and lateral radiograph in standing. Severity of complication is rated as mild, moderate or severe.
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Assessment method [12]
347794
0
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Timepoint [12]
347794
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [13]
347795
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Presence of long term adverse event of lower limb sensory impairment as reported by the clinician and/or parent
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Assessment method [13]
347795
0
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Timepoint [13]
347795
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Secondary outcome [14]
347796
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Presence of long term adverse event of bladder/bowel dysfunction as reported by the clinician and/or parent
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Assessment method [14]
347796
0
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Timepoint [14]
347796
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Baseline and at 1, 2, 5 and 10 years post Selective Dorsal Rhizotomy surgery
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Eligibility
Key inclusion criteria
Children who have undergone or are undergoing selective dorsal rhizotomy procedure in Australia or overseas who consent to have their data collected in the registry.
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Minimum age
No limit
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Maximum age
18
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
Nil
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
Statistical analysis will be undertaken when a sample size of 14 is achieved. This is based on a previous study (Van Schie et al, 2011) where GMFM-66 scores increased from 69 (SD 8.9) to 76.2 (SD 8.5) in children classified as GMFCS I or II one year following SDR. This was determined using a paired t test with a power of 0.8 and an alpha of 0.05.
Descriptive data will be described using means and standard deviations, medians and ranges, or frequencies and proportions depending on the type and distribution of the data.
The primary research question (gross motor function) will focus on the results from the GMFM-66. Changes in gross motor function over time will firstly be assessed using the raw scores. When two time points are available a paired t test will be used. When three or more time points exist then a mixed model approach will be used to account for the correlation between the time points. Given the likely small sample test or model assumptions may be violated. Transformation of the data or non-parametric methods will then be utilized.
The GMFM-66 allows for comparison with reference curves over time allowing for the longitudinal assessment of the data (Hanna et al, 2008). Each child’s GMFM-66 score will be referenced against the average development pattern for children in his or her GMFCS level. After assigning centiles a change in function between 2 percentile measurements will be determined using an 80% coverage probability. For children functioning at GMFCS I a second percentile measurement has an 80% chance of being ±20 of the first measurement. For GMFCS level II the cut off is ±19.9. At each time point children will be classified as declined, increased or stable in their gross motor function based on these cut offs. This technique has been described previously in the literature (Hanna et al 2008, Bolster et al 2013). The frequency and proportion of children in each group will be examined over time and compared to expected outcomes from the CP population.
Differences in outcomes between procedure locations (overseas vs Australia) will be compared using independent t tests, Mann Whitney U test, or Chi square test, depending on the type and distribution of the data.
The remaining outcome measures (gait, quality of life, goal attainment and pain) will be analysed using paired t tests when 2 time points exist. When three or more time points exist then a mixed model approach will be used. Given the likely small sample model assumptions may be violated. Transformation of the data or non-parametric methods will then be employed.
All data will be analysed using Stata 14.1 (StataCorp, College Station, Texas). Alpha will be set at 0.05.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
12/10/2017
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Date of last participant enrolment
Anticipated
17/05/2022
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Actual
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Date of last data collection
Anticipated
1/12/2032
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Actual
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Sample size
Target
80
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Accrual to date
27
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,WA,VIC
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Recruitment hospital [1]
10968
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [2]
10969
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Lady Cilento Children's Hospital - South Brisbane
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Recruitment hospital [3]
10970
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Princess Margaret Hospital - Subiaco
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Recruitment hospital [4]
10971
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [5]
10972
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
22757
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2145 - Westmead
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Recruitment postcode(s) [2]
22758
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4101 - South Brisbane
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Recruitment postcode(s) [3]
22759
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6008 - Subiaco
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Recruitment postcode(s) [4]
22760
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3052 - Parkville
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Recruitment postcode(s) [5]
22761
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5006 - North Adelaide
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Funding & Sponsors
Funding source category [1]
299561
0
Charities/Societies/Foundations
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Name [1]
299561
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The Research Foundation, Cerebral Palsy Alliance
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Address [1]
299561
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CPA Research Grants
PO Box 6427,
Frenchs Forest
NSW 2086
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Country [1]
299561
0
Australia
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Funding source category [2]
299649
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Other Collaborative groups
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Name [2]
299649
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The Centre of Research Excellence in Cerebral Palsy
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Address [2]
299649
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Murdoch Children's Research Institute
Royal Children's Hospital
Flemington Road, Parkville
Victoria 3052
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Country [2]
299649
0
Australia
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Primary sponsor type
Hospital
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Name
The Children's Hospital at Westmead
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Address
Kids Rehab
The Children’s Hospital at Westmead
Locked Bag 4001
Westmead
NSW 2145
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Country
Australia
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Secondary sponsor category [1]
298877
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Hospital
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Name [1]
298877
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Queensland Children's Hospital
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Address [1]
298877
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Paediatric Rehabilitation Service Queensland Children's Hospital, 501 Stanley Street South Brisbane 4101
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Country [1]
298877
0
Australia
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Secondary sponsor category [2]
298878
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Hospital
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Name [2]
298878
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Women's and Children's Hospital
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Address [2]
298878
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Paediatric Rehabilitation Department
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country [2]
298878
0
Australia
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Secondary sponsor category [3]
298880
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Hospital
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Name [3]
298880
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The Royal Children's Hospital, Melbourne
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Address [3]
298880
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Victorian Paediatric Rehabilitation Service
The Royal Children's Hospital
50 Flemington Road
Parkville,
Victoria 3052
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Country [3]
298880
0
Australia
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Secondary sponsor category [4]
299026
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Hospital
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Name [4]
299026
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Perth Children's Hospital
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Address [4]
299026
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Department of Paediatric Rehabilitation Perth Children's Hospital Locked Bag 2010 Nedlands, Western Australia 6909
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Country [4]
299026
0
Australia
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Other collaborator category [1]
280148
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Individual
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Name [1]
280148
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Dr Simon Paget
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Address [1]
280148
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Kids Rehab
The Children’s Hospital at Westmead
Locked Bag 4001
Westmead
NSW 2145
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Country [1]
280148
0
Australia
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Other collaborator category [2]
280149
0
Individual
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Name [2]
280149
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Jenny Lewis
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Address [2]
280149
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Kids Rehab
The Children’s Hospital at Westmead
Locked Bag 4001
Westmead
NSW 2145
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Country [2]
280149
0
Australia
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Other collaborator category [3]
280150
0
Individual
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Name [3]
280150
0
Nadine Smith
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Address [3]
280150
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Department of Paediatric Rehabilitation Perth Children's Hospital Locked Bag 2010 Nedlands, Western Australia 6909
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Country [3]
280150
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Australia
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Other collaborator category [4]
280151
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Individual
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Name [4]
280151
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Dr Emma Richardson
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Address [4]
280151
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Department of Paediatric Rehabilitation Perth Children's Hospital Locked Bag 2010 Nedlands, Western Australia 6909
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Country [4]
280151
0
Australia
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Other collaborator category [5]
280152
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Individual
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Name [5]
280152
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Felicity Baker
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Address [5]
280152
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Paediatric Rehabilitation Department
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country [5]
280152
0
Australia
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Other collaborator category [6]
280153
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Individual
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Name [6]
280153
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Dr Olivia Lee
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Address [6]
280153
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Victorian Paediatric Rehabilitation Service
The Royal Children's Hospital
50 Flemington Road
Parkville,
Victoria 3052
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Country [6]
280153
0
Australia
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Other collaborator category [7]
280154
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Individual
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Name [7]
280154
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Pam Thomason
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Address [7]
280154
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Victorian Paediatric Rehabilitation Service
The Royal Children's Hospital
50 Flemington Road
Parkville,
Victoria 3052
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Country [7]
280154
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Australia
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Other collaborator category [8]
280155
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Individual
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Name [8]
280155
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Dr Andrew Tidemann
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Address [8]
280155
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Paediatric Rehabilitation Department
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country [8]
280155
0
Australia
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Other collaborator category [9]
280156
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Individual
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Name [9]
280156
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Natasha Bear
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Address [9]
280156
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Department of Clinical Research and Education Child Adolescent
Princess Margaret Hospital for Children
GPO Box D184, Perth
Western Australia 6840
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Country [9]
280156
0
Australia
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Other collaborator category [10]
280157
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Individual
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Name [10]
280157
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Dr Adam Fowler
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Address [10]
280157
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Department of Neurosurgery
The Children’s Hospital at Westmead
Locked Bag 4001
Westmead
NSW 2145
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Country [10]
280157
0
Australia
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Other collaborator category [11]
280158
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Individual
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Name [11]
280158
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Dr Adam Scheinberg
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Address [11]
280158
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Victorian Paediatric Rehabilitation Service
The Royal Children's Hospital
50 Flemington Road
Parkville,
Victoria 3052
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Country [11]
280158
0
Australia
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Other collaborator category [12]
280159
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Individual
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Name [12]
280159
0
Meredith Wynter
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Address [12]
280159
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Paediatric Rehabilitation Service Queensland Children's Hospital, 501 Stanley Street South Brisbane 4101
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Country [12]
280159
0
Australia
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Other collaborator category [13]
280160
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Individual
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Name [13]
280160
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Dr Kim McLennan
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Address [13]
280160
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Paediatric Rehabilitation Service Queensland Children's Hospital, 501 Stanley Street South Brisbane 4101
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Country [13]
280160
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300458
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Sydney Children's Hospitals Network Human Research Ethics Committee
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Ethics committee address [1]
300458
0
Research Ethics Office Locked Bag 4001 Westmead NSW 2145
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Ethics committee country [1]
300458
0
Australia
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Date submitted for ethics approval [1]
300458
0
21/10/2016
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Approval date [1]
300458
0
15/05/2017
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Ethics approval number [1]
300458
0
HREC/16/SCHN/383
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Ethics committee name [2]
300468
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Children and Adolescent Health Service Human Research Ethics Committee
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Ethics committee address [2]
300468
0
GPO Box D184, Perth, 6840, Western Australia
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Ethics committee country [2]
300468
0
Australia
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Date submitted for ethics approval [2]
300468
0
02/02/2017
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Approval date [2]
300468
0
10/08/2017
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Ethics approval number [2]
300468
0
RGS0000000323
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Summary
Brief summary
Selective dorsal rhizotomy (SDR) is a well-established neurosurgical intervention intended to permanently reduce spasticity in the lower limbs and improve mobility in selected children with cerebral palsy. The aim of this study is to establish a retrospective and prospective national registry of relevant data pertaining to children undergoing SDR in Australia, and overseas (selection, intervention and outcome). Centres across Australia have agreed on a group of standardised assessments for children undergoing SDR both prior to and after the surgical procedure. The objective of collecting this data is to improve understanding of the short, medium and long term outcomes and any adverse effects of the intervention, and to provide clinicians with information to guide families considering this intervention. Families of children who have undergone or are undergoing SDR (in Australia, and overseas) will be asked to consent to information relevant to SDR being stored in a research-specific online database. Information will be collected from the children's routine clinical assessments. Information will be stored without identifying details to improve privacy. Participation in this trial is voluntary. Data collected in the registry will identify the characteristics of Australian children who have undergone SDR. In addition to details of the surgery including surgical complications; long term adverse events; and outcomes related to the International Classification of Functioning, Disability and Health domains of body structure and function, activity and participation. The primary and secondary outcome measures have been developed for the CP and/or paediatric population and will be collected at baseline, and at one, two, five and ten years post intervention. These include gross motor function and mobility, achievement of goals, pain and quality of life. The need for further interventions after SDR surgery will be collected and include spasticity management and orthopaedic interventions in the ten years following SDR. The prevalence of any long term adverse effects will be collected in the ten years following SDR. The data collected pertaining to adverse events include spine and foot deformity, hip subluxation, sensory impairment and bladder/bowel dysfunction.
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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
83726
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Dr Simon Paget
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Address
83726
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Kids Rehab
The Children's Hospital at Westmead
Locked Bag 4001
Westmead NSW 2145
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Country
83726
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Australia
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Phone
83726
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+61 2 9845 0833
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Fax
83726
0
+61 2 9845 0685
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Email
83726
0
[email protected]
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Contact person for public queries
Name
83727
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Simon Paget
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Address
83727
0
Kids Rehab
The Children's Hospital at Westmead
Locked Bag 4001
Westmead NSW 2145
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Country
83727
0
Australia
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Phone
83727
0
+61 2 9845 0833
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Fax
83727
0
+61 2 9845 0685
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Email
83727
0
[email protected]
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Contact person for scientific queries
Name
83728
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Simon Paget
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Address
83728
0
Kids Rehab
The Children's Hospital at Westmead
Locked Bag 4001
Westmead NSW 2145
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Country
83728
0
Australia
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Phone
83728
0
+61 2 9845 0833
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Fax
83728
0
+61 2 9845 0685
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Email
83728
0
[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
All data is de-identified and analysed as a multicentre cohort. No individual data will be made available. Results will be published in peer-reviewed journals and at local, National and International conferences.
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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.
Download to PDF