Effect of Multidimensional Trunk Training in Children With Cerebral Palsy

Condition(s) studied

Investigational drug(s) / intervention(s)

Control Group: Participants in the control group will receive two face-to-face physiotherapy sessions and one asynchronous video-based exercise training session per week for eight weeks. Following the baseline assessments, a conventional exercise program will be individually planned by the physiotherapist for each child. Each 60-minute session will include strengthening exercises for upper and lower extremity muscles, active and passive stretching exercises for spastic muscles, static and dynamic balance training in standing, and gait exercises.

Intervention Group: Following baseline assessments, a personalized 60-minute exercise program will be developed by the physiotherapist for each child in the intervention group, consisting of two face-to-face sessions and one asynchronous video-based session per week for eight weeks. Each session will include 30 minutes of multidimensional trunk-focused exercises-such as static and dynamic trunk control (e.g., reaching, rotational movements), scapular and pelvic mobilizations, isolated muscle training, proprioceptive activities, and core strengthening-followed by 30 minutes of conventional therapy, including upper and lower extremity strengthening, stretching for spastic muscles, balance training in standing, and gait exercises.

Study summary

This study investigates the effects of a personalized, multidimensional trunk-focused exercise program combined with conventional rehabilitation on postural control, gait, selective motor control, spasticity, activity participation, and quality of life in children with spastic cerebral palsy. Participants will be randomly assigned to an intervention group receiving trunk-focused exercises plus conventional therapy or a control group receiving only conventional therapy over an eight-week period with thrice-weekly sessions (two face-to-face, one home-based via video guidance). The study also incorporates caregiver-supported home exercises facilitated by a web-based platform and mobile application to enhance adherence and sustainability. Outcomes will be assessed pre- and post-intervention to evaluate the program's efficacy in improving motor function and daily activity engagement.

Eligibility

Primary outcome measure(s)

• Trunk Control Measurement Scale (TCMS) — Baseline and after 8 weeks
  The TCMS consists of two main subcomponents: static and dynamic sitting balance. The static sitting balance section evaluates static trunk control during upper and lower extremity movements and has been shown to be a valid and reliable tool in children with cerebral palsy (Heyrman et al., 2011). The dynamic sitting balance section is further divided into two subcategories: selective movement control and dynamic reaching. The selective movement control subcomponent assesses the pelvis's ability to perform selective movements in all three planes (flexion-extension, lateral flexion, and rotation) while seated on a support surface. The dynamic reaching subcomponent evaluates performance during reaching tasks. The scale consists of 15 items, with a total score ranging from 0 to 58, where higher scores indicate better trunk control.
• Pediatric Balance Scale (PBS) — Baseline and after 8 weeks
  The Pediatric Balance Scale is an adaptation of the Berg Balance Scale, originally developed for adults, for use in children. It is a functional balance assessment tool consisting of 14 items that evaluate parameters such as sitting to standing, standing, transfers, stepping, and turning (Franjoine M.R. et al., 2003). The scale has been validated for use in children with cerebral palsy in Turkish populations (Erden A. et al., 2021).

Trial sites (1)

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