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CTRI Number  CTRI/2023/03/051189 [Registered on: 29/03/2023] Trial Registered Prospectively
Last Modified On:
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Ayurveda 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   Efficacy of Ayurvedic Management in Spastic Cerebral Palsy 
Scientific Title of Study   Efficacy of Ayurveda treatment protocol with and without Salavana Upanaha Sweda in the management of Spastic Cerebral Palsy – An open labelled randomized comparative clinical trial 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Manju 
Designation  MD Scholar 
Affiliation  Institute of Teaching and Research in Ayurveda, Jamnagar 
Address  Department of kaumarbhritya, 5th floor, Institute Building, Institute of Teaching and Research in Ayurveda, Opposite B- Division Police Station, Gurudwara Road, Jamnagar

Jamnagar
GUJARAT
361008
India 
Phone  9588105688  
Fax    
Email  anjurana1530@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr V K Kori 
Designation  Assistant Professor 
Affiliation  Institute of Teaching and Research in Ayurveda, Jamnagar 
Address  Department of kaumarbhritya, 5th floor, Institute Building, Institute of Teaching and Research in Ayurveda, Opposite B- Division Police Station, Gurudwara Road, Jamnagar

Jamnagar
GUJARAT
361008
India 
Phone  9374548475  
Fax    
Email  drvkkori@yahoo.co.in  
 
Details of Contact Person
Public Query
 
Name  Dr V K Kori 
Designation  Assistant Professor 
Affiliation  Institute of Teaching and Research in Ayurveda, Jamnagar 
Address  Department of kaumarbhritya, 5th floor, Institute Building, Institute of Teaching and Research in Ayurveda, Opposite B- Division Police Station, Gurudwara Road, Jamnagar

Jamnagar
GUJARAT
361008
India 
Phone  9374548475  
Fax    
Email  drvkkori@yahoo.co.in  
 
Source of Monetary or Material Support  
Dept. of Kaumarbhritya, 5th floor, Institute Building, ITRA, Jamnagar 
 
Primary Sponsor  
Name  Institute of Teaching and Research in Ayurveda 
Address  Opposite B- Division Police Station, Gurudwara Road, ITRA, Jamnagar 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Manju  Institute of Teaching and Research in Ayurveda  4th floor, IPD building, Dept. of Kaumarbhritya, ITRA
Jamnagar
GUJARAT 
9588105688

anjurana1530@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethical Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition:G801||Spastic diplegic cerebral palsy. Ayurveda Condition: VATAVYADHIH,  
 
Intervention / Comparator Agent  
snoIntervention/ComparatorTypeDrug-TypeProcedure NameDetails
1Intervention ArmDrugClassical(1) Medicine Name: Shunthi Churna, Reference: Bhavprakash Nighantu- Haritakyadi Varga – Sloka no. 44, Route: Oral, Dosage Form: Churna/ Powder, Dose: 500(mg), Frequency: bd, Bhaishajya Kal: Pragbhakta, Duration: 3 Days, anupAna/sahapAna: Yes(details: Lukewarm Water), Additional Information: In both groups, Deepana – Pachana will be given for 3 days with Shunthi Churna before initiation of first course.
2Intervention ArmProcedure-udvartanam, उद्वर्तनम् (Procedure Reference: Astanga Hridya, Sutra sathan 2/14, Pg. 26 , Procedure details: Udvartana: With Yava and Kulattha Churna in the same proportion will be done for 3 days. )
3Intervention ArmProcedure-aBya~ggaH, अभ्यंग  (Procedure Reference: Ch. Chi. 28/ 81, Pg. 791, Procedure details: Abhyanga with Bala Taila will be done for 20 min. followed by Nadi Swedana for 7 days.)
4Intervention ArmProcedure-nADIsvedaH, नाडीस्वेदः (Procedure Reference: Ch. Chi. 28/78, Pg. 791, Procedure details: Abhyanga with Bala Taila will be done for 20 min. followed by Nadi Swedana for 7 days.)
5Intervention ArmProcedure-pratimarSaH, प्रतिमर्श (Procedure Reference: Astanga Hridya, Sutra Sathan 20/1, Pg.172 Ch. Siddhi 8/116-117, Procedure details: Purva Karma - Advice the patient to lie down on Nasya table. Mrudu Abhyanga should be done on scalp, forehead, face, and neck for 5-10 minutes by medicated oil like Bala Taila followed by mild Swedana (Sudation). According to Ayurvedic classics Swedana should not be given to the head. Pradhana karma- The patient should be lie down in supine position and head should be “Pralambita” i.e hanging down slightly .Then, raise the tip of the patients nose with his left thumb, and with the right han)
(1) Medicine Name: Astanga Ghrita, Reference: Astanga Hridya, Uttar Tantra 1/43-44, Route: Nasal, Dosage Form: Ghrita, Dose: 2(drops), Frequency: od, Duration: 7 Days
6Intervention ArmProcedure-bastikarma/vastikarma, बस्तिकर्म/वस्तिकर्म (Procedure Reference: Chaturbhadra Kalpa Basti- Kashyapa Samhita, Khila Sathan 8/23, Procedure details: This protocol of Basti administration include, in beginning four Sneha Basti then four Aasthapana Basti and at last four Sneha Basti (Total 8 Sneha Basti and 4 Aasthapana Basti). Anuvasana Basti: Bala Taila Aasthpana Basti: Madhutailika Basti (Acharya YT, Ambikadattashastri, editors, Sushruta Samhita of Sushrut, Chaukhambha Sanskrit Santhan, Varanasi, Ver. 101. Reprinted Edition Chikitsa Sthana. Ch. 38, Ver. 101. pg no.216) )
7Intervention ArmProcedure-upanAhasvedaH (sAgniH, उपनाहस्वेदः (साग्निः) (Procedure Reference: Salavana Upanaha Sweda- Astanga Hridya, Sutra Sathan 17/3,, Procedure details: Quantity sufficient of the mixture of Godhumadi Churna will be taken. Thickness of Lepa: Q.S. Duration: For 6 to 8 Hours. Mode of Administration: Purva Karma: Sarvanga Abhyanga will be done with Bala Taila for a period of 20 minutes followed by Ushana jala snana. Pradhana Karma: • This paste will be applied to the afflicted limb in Pratiloma Gati at a temperature that would not cause burns in the child forming the first layer in contact with the skin. • The next step is application )
8Intervention ArmDrugOther than Classical(1) Medicine Name: Medhya Churna, Reference: NA, Route: Oral, Dosage Form: Churna/ Powder, Dose: 2(g), Frequency: bd, Bhaishajya Kal: Adhobhakta, Duration: 83 Days, anupAna/sahapAna: Yes(details: -Madhu), Additional Information: -
9Comparator ArmDrugClassical(1) Medicine Name: Shunthi Ckurna, Reference: Bhavprakash Nighantu- Haritakyadi Varga – Sloka no. 44, Route: Oral, Dosage Form: Churna/ Powder, Dose: 500(mg), Frequency: bd, Bhaishajya Kal: Pragbhakta, Duration: 3 Days, anupAna/sahapAna: Yes(details: -Lukewarm water), Additional Information: -
10Comparator ArmProcedure-udvartanam, उद्वर्तनम् (Procedure Reference: Astanga Hridya, Sutra sathan 2/14, Pg. 26, Procedure details: Udvartana: With Yava and Kulattha Churna in the same proportion will be done for 3 days.)
11Comparator ArmProcedure-saravA~gga, सर्वांग  (Procedure Reference: Ch. Chi. 28/ 81, Pg. 791, Procedure details: Abhyanga with Bala Taila will be done for 20 min. followed by Nadi Swedana for 7 days)
12Comparator ArmProcedure-nADIsvedaH, नाडीस्वेदः (Procedure Reference: Ch. Chi. 28/78, Pg. 791, Procedure details: Abhyanga with Bala Taila will be done for 20 min. followed by Nadi Swedana for 7 days.)
13Comparator ArmProcedure-pratimarSaH, प्रतिमर्श (Procedure Reference: Astanga Hridya, Sutra Sathan 20/1, Pg.172 Ch. Siddhi 8/116-117, Procedure details: Purva Karma - Advice the patient to lie down on Nasya table. Mrudu Abhyanga should be done on scalp, forehead, face, and neck for 5-10 minutes by medicated oil like Bala Taila followed by mild Swedana (Sudation). According to Ayurvedic classics Swedana should not be given to the head. Pradhana karma- The patient should be lie down in supine position and head should be “Pralambita” i.e hanging down slightly .Then, raise the tip of the patients nose with his left thumb, and with the right han)
(1) Medicine Name: Astanga Ghrita, Reference: Astanga Hridya, Uttar Tantra 1/43-44, Route: Nasal, Dosage Form: Ghrita, Dose: 2(drops), Frequency: od, Duration: 7 Days
14Comparator ArmProcedure-bastikarma/vastikarma, बस्तिकर्म/वस्तिकर्म (Procedure Reference: Chaturbhadra Kalpa Basti- Kashyapa Samhita, Khila Sathan 8/23, Procedure details: This protocol of Basti administration include, in beginning four Sneha Basti then four Aasthapana Basti and at last four Sneha Basti (Total 8 Sneha Basti and 4 Aasthapana Basti). Anuvasana Basti: Bala Taila Aasthpana Basti: Madhutailika Basti (Acharya YT, Ambikadattashastri, editors, Sushruta Samhita of Sushrut, Chaukhambha Sanskrit Santhan, Varanasi, Ver. 101. Reprinted Edition Chikitsa Sthana. Ch. 38, Ver. 101. pg no.216))
15Comparator ArmDrugOther than Classical(1) Medicine Name: Medhya Churna, Reference: NA, Route: Oral, Dosage Form: Churna/ Powder, Dose: 2(g), Frequency: bd, Bhaishajya Kal: , Duration: , anupAna/sahapAna: No, Additional Information:
(2) Medicine Name: 83 Days, Reference: NA, Route: -Madhu, Dosage Form: Churna/ Powder, Dose: (), Frequency: , Bhaishajya Kal: , Duration: , anupAna/sahapAna: No, Additional Information:
 
Inclusion Criteria  
Age From  1.00 Year(s)
Age To  10.00 Year(s)
Gender  Both 
Details  Children of Spastic Cerebral Palsy with developmental disability either physical or mental in mild or moderate degree as compared to normal children 
 
ExclusionCriteria 
Details  Children of Ataxic, Athetoid and Dyskinetic CP with major congenital disorders, chromosomal disorders and other disease status viz. Juvenile DM, CHD.

Patients with acute infections.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   On-site computer system 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
Change in Muscle spasticity checked via Modified Ashworth scale (MAS) and contracture by goniometry.

Change in gross motor function by GMFCS E&R.

Improvement in ADL (Activity of Daily Living) scale.
 
On day 0 and after 83 days
 
 
Secondary Outcome  
Outcome  TimePoints 
Improvement in Muscle power checked via MRC scale. (BT and AT)  On day 0 and after 83 days 
 
Target Sample Size   Total Sample Size="20"
Sample Size from India="20" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   25/04/2023 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Not yet Published 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  
Introduction: Among various neurodevelopmental disorders, Cerebral palsy is the commonest chronic motor disability that affects childhood. It is the diagnostic term used to describe a group of permanent disorders of movement and posture causing activity limitation that are attributed to nonprogressive disturbances in the developing fetal or infant brain.
Significance:As cerebral palsy is an umbrella term, a single therapy can not cure this. In this condition, Ayurvedic protocol of management can enhance the quality of life of the suffering child. It has been proved in earlier studies that Panchakarma therapy has a great role in the management of spastic CP. Hence the prime goal of the study is to find out the complete treatment protocol that can reduce spasticity, contracture, rigidity, disabilities and thereby providing maximum quality of life.
Aim and Objectives : To evaluate and compare the efficacy of Ayurveda treatment protocol (Deepana-Pachana, Udvartana, Abhyanga-Swedana, Astanga Ghrita Pratimarsha Nasya, Chaturbhadra Kalpa Basti and Medhya Churna orally) along with and without Salavana Upanaha Sweda in the management of Spastic Cerebral Palsy.
Material and methods: The present study is an open labelled randomized comparative clinical trial on Spastic Cerebral Palsy in children of either sex between 1 year to 10 years of age.
 20 pre-diagnosed and newly diagnosed patients of spastic cerebral palsy will be enrolled in two groups with 10 patients in each group. 
 For that, Group A is provided with  Ayurveda Treatment Protocol (Deepana-Pachana, Udvartana, Abhyanga-Swedana, Astanga Ghrita Pratimarsha Nasya, Chaturbhadra Kalpa Basti and Medhya Churna orally)  along with Salavana Upanaha Sweda,  
while Group B is given Ayurveda Treatment Protocol (Deepana-Pachana, Udvartana, Abhyanga-Swedana, Astanga Ghrita Pratimarsha Nasya, Chaturbhadra Kalpa Basti and Medhya Churna orally) without Salavana Upanaha Sweda. 
The total duration of study is 83 days and follow up of 30 days will be carried out.
Results and Discussion: Data generated during the above study will be presented in a systemic manner and shall be analyzed statistically. Follow up: After completion of therapy, follow up will be done for 1 month to assess the status of patient, where the patient will be asked to report. 
Adverse effects: This proposal will be reviewed and approved by ITRA, Institutional Ethics Committee, which is having the responsibility to protect the research participants from harm. These drugs have no known unwanted effects. It is possible that it may also cause some problems that we are not aware of. Adverse drug reactions if any observed will be reported to the Pharmacovigilance cell of ITRA.
 
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