Abstract
Purpose: This study aimed to investigate the effects of trunk training on body function and structures of children with spastic cerebral palsy (CP). Methods: Children included in this study were classified according to the Gross Motor Function Classification System (GMFCS) and divided into two groups by stratified randomization based on their GMFCS levels and ages. A total of 36 children with bilateral spastic CP were recruited for this study, and 19 children (4 females, 15 males, age=8.81±3.92 years) were included in the trunk training group, and 17 children (6 females, 11 males, age=10.44±4.63 years) were included in the control group. Muscle tone of upper and lower extremity muscles was assessed using the Modified Tardieu Scale (MTS), and muscle activation of the trunk muscles was assessed using Surface Electromyography during rest (sEMG minimum) and forward reaching (sEMG maximum) at baseline and after an eight-week intervention. Results: When the therapy-induced changes were considered, it was seen that there was no difference in muscle tone in both groups (p>0.05). The sEMG maximum scores for erector spinae muscles (p=0.025 for right and p=0.006 for left) improved in the trunk training group. There was no change in the sEMG scores of lumbar multifidus, M. rectus abdominis, internal oblique-transversus abdominis, external oblique, and M. gluteus maximus muscles (p>0.05). Conclusion: Individually-structured trunk training is a promising method to increase activation of trunk extensors. This intervention can be used safely without the risk of increasing muscle tone of upper and lower extremities in children with CP.
Highlights
A considerable amount of definitions of cerebral palsy (CP) can be found in the literature
We designated 65 children with CP to include in this study
One child from trunk training group (TTG) had a seizure during the intervention period, and he did not develop seizure at the therapy session, since this condition was one of our exclusion criteria, this child was dropped from the study
Summary
A considerable amount of definitions of cerebral palsy (CP) can be found in the literature. Half of the children with CP needs assistance to stand or walk because they have difficulty in achieving their postural alignment and stability against gravity [1]. They have difficulty in maintaining a stable sitting position, and they generally sit in an asymmetric position with increased kyphosis [2]. Coordinated activation of flexors and extensors of the trunk and hip is necessary for maintaining a balanced sitting position. Trunk control and active participation of trunk muscles are necessary to ensure a stable support surface during upper and lower extremity functions, including reaching and walking [4,5]. Impaired upper extremity kinematics during reaching is related with abnormal trunk movements, including excessive anterior positioning of the trunk
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