A Randomised Controlled Study to Investigate Effects of Bobath Based Trunk Control Training on Motor Function of Children with Spastic Bilateral Cerebral Palsy

Gonca Arı,Mintaze Kerem Günel

doi:10.4236/ijcm.2017.84020

Abstract

Purpose: The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and is often observed as a deficiency in children with CP. Material and Methods: Forty children with spastic bilateral CP, ages between 3 to 10 years and with Gross Motor Function Classification System (GMFCS) level I, II, and III were included in this study. Children were divided into two groups using randomization and in training group; Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks. In control group, existing physiotherapy program, 45 minutes for two days a week, continued. Any addition was not made into the existing program of the control group. Modified Ashworth Scale (MAS), Pediatric Berg Balance Scale (PBBS), Trunk Control Measurement Scale (TCMS), 1 Minute Walking Test (1MWT), Timed Up and Go Test (TUG) were applied to both groups before and after 6 weeks. Moreover, trunk muscle strength of children was evaluated. Results: After therapy, differences were found in results of MAS and PBBS, and trunk extensor strength between the training group and the control group in favor of the training group (p < 0.05). In addition, TCMS, 1MWT, TUG test and showed significant improvement compared to the average of the pre-treatment of the trunk muscle strength (p < 0.05). In addition, after treatment, training group’s averages of TCMS, PBBS, 1MWT, YUG test and all trunk muscle strength were higher compared to the ones before treatment (p < 0.05). Conclusion: This study shows that adding exercises which aim trunk to conventional physiotherapy and exercise programs of children with CP, affects motor function positively.

Highlights

Cerebral Palsy (CP) is described as a permanent but non progressive impairment of the immature brain that is affected in the prenatal, perinatal or postnatal period [1]
The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and is often observed as a deficiency in children with CP
Children were divided into two groups using randomization and in training group; Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks

Summary

Introduction

Cerebral Palsy (CP) is described as a permanent but non progressive impairment of the immature brain that is affected in the prenatal, perinatal or postnatal period [1]. Contractures and deformities which are proportionally consisted with the type and severity of CP can lead to postural disorders. Immature trunk control, abnormal tonus and disorder of postural control are affecting children’s physical development negatively [1]. Trunk control is a complicated relation between skeletal muscles and neural systems. The primary neural components to achieve trunk control are neuromuscular synergy responses of motor process, visual, vestibular and somatosensorily systems which are included in the sensorial process. Beside these, it includes high level integration process that leads to intuitional trunk control [2]

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