Trunk Control Measurement Scale Research Articles

A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components.

We compared children with hemiplegic and diplegic cerebral palsy (CP) using the conceptual framework of the International Classification of Functioning, Disability and Health: Child and Youth version (ICF-CY). We enrolled 42 children with CP aged 5 - 13 years old (M age = 9.57, SD = 2.8 years). We assessed their trunk control and dynamic balance with the Trunk Control Measurement Scale (TCMS) and the Timed Up and Go test (TUG), and we used ABILHAND-Kids and Assessment of Life Habits (Life-H) to assess their manual ability and participation with activities of daily living. We administered the European Child Environment Questionnaire (ECEQ) to identify relevant environmental factors. We employed structural equation modeling (SEM) to identify specific factors contributing to potential differences between these CP groups. Children with hemiplegic CP demonstrated significantly better outcomes in terms of trunk control, dynamic balance, and environmental factors compared to those with diplegic CP (p < .05). In contrast, children with diplegic CP demonstrated superior outcomes regarding manual ability, compared to those with hemiplegic CP (p < .001). In our structural equation models, trunk control strongly predicted both dynamic balance (0.75) and environmental factors (0.74). Moreover, the relationships between trunk control and participation in daily and social activities were 0.54 and 0.47, respectively. Impaired trunk control and dynamic balance were significant contributors to increased activity restrictions and environmental barriers in children with diplegic CP. This suggests that improving disability and functioning in children with diplegic CP requires a focus on trunk control training and dynamic balance exercises.

Validity and reliability of the Sitting Assessment Scale in cerebral palsy.

The aim of this study was to examine the validity and reliability of the Sitting Assessment Scale (SAS) in individuals with cerebral palsy (CP). The study included 34 individuals with a diagnosis of spastic CP. Individuals were evaluated with the Gross Motor Function Classification System and the Manual Ability Classification System. SAS and Trunk Control Measurement Scale (TCMS) were applied to the participants. The intraclass correlation coefficient (ICC) was calculated to determine the intraobserver and interobserver reliability of the scale scored by three different physiotherapists at two different time intervals. Internal consistency was calculated with Cronbach's ⍺ coefficient. The fit between SAS and TCMS for criterion-dependent validity was evaluated using Pearson Correlation Analysis. According to the GMFCS level, 79.41% of the children were mildly (Level I-II), 14.71% were moderately affected (level III), and 5.88% were severely affected (level IV). Intra > observer and interobserver reliability values of SAS were extremely high (ICCinterrater > 0.923, ICCintrarater > 0.930). It was observed that the internal consistency of SAS had high values (Cronbach ⍺test > 0.822, Cronbach ⍺retest > 0.804). For the criterion-dependent reliability; positive medium correlations found between SAS with Total TCMS Static Sitting Balance (r = 0.579, p < 0.001), with TCMS Selective Movement Control (r = 0.597, p < 0.001), with TCMS Dynamic Reaching (r = 0.609, p < 0.001), and with TCMS Total (r = 0.619, p < 0.001). SAS was found to have high validity and reliability in children with CP. In addition, the test-retest reliability of the scale was also high. SAS is a practical tool that can be used to assess sitting balance in children with CP.

Correlations between Trunk Control and Balance in Children with Bilateral Spastic Cerebral Palsy.

Impairments of postural responses are a salient feature of children with cerebral palsy (CP). While the systems approach describes balance in seven components, the relationship between trunk control and balance in children with CP has not been previously examined with all seven of these components. In this study, we aimed to identify correlations between trunk control and all seven systems approach balance components in children with bilateral spastic CP. Our participants were 30 children (M age = 11.83, SD = 2.32 years) with CP having a Gross Motor Function Classification System level ranging from I to III. We assessed trunk control with the Trunk Control Measurement Scale, including static and dynamic balance (selective voluntary control and reaching). Balance in standing was assessed using Kids-Mini-BESTest involving four domains: anticipatory, reactive, sensory orientation and stability in gait. We used Spearman's rank correlations to correlate trunk control and balance, and we obtained a moderate correlation between the trunk control measurement scale and the Kids-Mini-BESTest in children with both bilateral spastic CP (rs = .618, p < .001) and spastic diplegic CP (rs = .52, p = .02). Analysis of the correlations between separate domains of the Kids-Mini-BESTest and the trunk control measurement scale subscales revealed moderate correlations between the static sitting balance subscale and all four domains of the Kids-Mini-BESTest. The dynamic selective motor control subscale of the trunk control measurement scale moderately correlated with the anticipatory domain of the Kids-Mini-BESTest. The dynamic reaching subscale also correlated moderately with anticipatory and stability in gait domains. This correlation was statistically significant in the 13 to 17-year-old age group and was strong among females, whereas the correlation was moderate in males. Trunk control was moderately associated with balance considering all the systems theory components of balance in children with bilateral spastic cerebral palsy.

Effectiveness of Abdominal Activation on Motor Control in Diplegic Cerebral Palsy: A Randomized Control Trial

Background: Cerebral palsy (CP) is a disorder of the nervous system manifested in movement, posture, muscle tone, and functional activity. Poor postural control is the most common problem related to CP. Neuro-developmental techniques, or facilitation techniques, were used to activate muscles and improve trunk control. Aim: To determine the influence of the effects of abdominal activation for correcting posture in spastic diaplegic CP children. Methods: A quantitative, randomized clinical trial was conducted, allocating 26 CP patients randomly into two groups: the control group and the treatment group. Baseline treatment was given to the control group, which included lower-limb passive stretching exercises and interrupted direct current. However, baseline treatment with neuro-developmental techniques was given to the treatment group. The measuring tool used for assessment of postural correction and stability was the trunk control measurement scale. Results: The study recruited 26 CP patients, of who 10 belonged to the age groups 8–10 years and 11–13 years, respectively, while 6 children were from the age group 14–15 years. An independent sample t-test was used for between-group analysis, and the results showed a significant improvement in the TCMS score post-treatment, as the p-value was 0.012, while within-group analysis was done by applying a paired sample t-test. There was a significant improvement in the treatment group (p-value 0.000) where NTD was applied, compared to the control group (p-value 0.096), where only baseline treatment was given. Implication: Neurodevelopmental approaches can improve trunk control in children with cerebral palsy, enhancing mobility, independence, posture, and functional skills. This reduces the risk of musculoskeletal issues and facilitates activity participation. Conclusion: The study showed significant improvement in postural control with the use of Neuro-developmental techniques in CP children. Children with cerebral palsy (CP) can benefit from improved trunk control using neurodevelopmental approaches, which can increase their mobility, independence, posture, ability to participate in activities, and functional skills. Keywords: Cerebral palsy (CP), Neuro-developmental techniques (NDT), Interrupted direct current (IDC).

Serebral Palsili Çocuklarda Fonksiyonel Seviye, Gövde Kontrolü ve Solunum Fonksiyonları Arasındaki İlişki

Cerebral palsy (CP) is a developmental disorder characterized by a group of movement and posture problems that occur as a result of a lesion in the immature brain and affect the development of the brain. Our study aimed to examine and compare the functional level, trunk control, and respiratory functions in children with cerebral palsy (CP). There were a total of 61 children with CP, 51% female, and 49% male, with a mean age of 11.21±3.02 years. Demographic and disease-related information were evaluated with ‘sociodemographic data form,’ functional levels with the ‘Gross Motor Function Classification System, trunk control with the ‘Trunk Control Measurement Scale’ (TCMS), and respiratory functions with ‘the respiratory function test’ using a spirometer. The functional levels of children with CP, 54% were Level 1, 26% were Level 2 and 20% were Level 3. In intergroup analysis, the mean trunk control of the children with Level 1 and 2 were statistically significantly higher than the children in Level 3 (p

Effect of Swiss Ball Stabilization Training on Trunk Control, Abdominal Muscle Thickness, Balance, and Motor Skills of Children With Spastic Cerebral Palsy: A Randomized, Superiority Trial

ObjectivesTo compare the effects of Swiss ball stabilization training (SBST) and stable surface stabilization training (SSST) on the trunk control, abdominal muscle thickness, balance, and motor skills of children with spastic cerebral palsy (CWSCP). DesignSingle-blind, randomized superiority trial. SettingGeneral Community and Referral Center. ParticipantsThirty CWSCP, aged 6-12 years, with Gross Motor Function Classification System levels I-III were randomly assigned to the SBST and SSST groups (N=30). InterventionsThe participants were randomized to receive either SBST or SSST for 5 weeks, 3 days a week. Outcome MeasuresThe Trunk Control Measurement Scale (TCMS), abdominal muscle thickness, Pediatric Balance Scale (PBS), standing and walking sections of Gross Motor Function Measure (GMFM-88), and mobility section of the Pediatric Evaluation of Disability Inventory (PEDI) were assessed. ResultsAfter 5 weeks of the intervention and 9 weeks of follow-up, the SBST group showed statistically significant improvements in the TCMS, GMFM-88, PEDI, thickness of the internal oblique muscle at rest and contraction, and thickness of the transverse abdominis muscle at rest and contraction compared with the SSST group (P<.0001). Contrarily, the thickness of the external oblique muscle increased statistically significantly in the SSST group compared with the SBST group after 5 weeks of the intervention and 9 weeks of follow-up both at rest (P<.0001 and P=.0001, respectively) and contraction (P=.015 and P=.017, respectively). No statistically significant difference was found between the groups regarding the PBS score after 5 weeks of intervention. ConclusionThe SBST could improve the trunk control, balance, and motor skills of CWSCP and increase the thickness of local abdominal muscles. Also, SBST was more effective than SSST for CWSCP.

Intensive Therapy of the Lower Limbs and the Trunk in Children with Bilateral Spastic Cerebral Palsy: Comparing a Qualitative Functional and a Functional Approach.

Few studies have examined the effect of intensive therapy on gross motor function and trunk control in children with cerebral palsy (CP). This study evaluated the effects of an intensive burst of therapy on the lower limbs and trunk by comparing qualitative functional and functional approaches. This study was designed as a quasi-randomized, controlled, and evaluator-blinded trial. Thirty-six children with bilateral spastic CP (mean age = 8 y 9 mo; Gross Motor Function Classification II and III) were randomized into functional (n = 12) and qualitative functional (n = 24) groups. The main outcome measures were the Gross Motor Function Measure (GMFM), the Quality Function Measure (QFM), and the Trunk Control Measurement Scale (TCMS). The results revealed significant time-by-approach interaction effects for all QFM attributes and the GMFM's standing dimension and total score. Post hoc tests showed immediate post-intervention gains with the qualitative functional approach for all QFM attributes, the GMFM's standing and walking/running/jumping dimension and total score, and the total TCMS score. The qualitative functional approach shows promising results with improvements in movement quality and gross motor function.

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy.

The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy. However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater's level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater's experience level.

Influence of Trunk Control on Gait Characteristics and Capacity in Children with Spastic Diplegic Cerebral Palsy

Aim: This study was conducted with the aim of to determine the relationship between trunk control and walking with time-distance characteristics and walking capacity in children with spastic diplegic cerebral palsy. Method: The study included 14 children with spastic diplegic cerebral palsy, aged between 7-13 years, who were Level I-II according to Gross Motor Function Classification System. Trunk control was assessed with the Trunk Control Measurement Scale (TCMS; static, dynamic, reach, and total score). Temporo-spatial characteristics of gait were evaluated with a posturography device NeuroCom Inc. by means of a force-plate, and step length (cm), step width (cm), walking speed (cm/s) and right-left symmetry in walking (%) were evaluated. Walking capacity was evaluated with the modified timed get up and go test (mTUG). Relationships between variables were evaluated with Spearman’s Correlation and linear regression analysis. Results: According to the correlation analysis, there was a significantly negative good relationship between the static subscale of TCMS and mTUG (r: -0.754; p&amp;lt;0.01), and a significantly negative excellent relationship between dynamic and reaching subscales and total TCMS scores (respectively r=-0.837; -0.861; -0.872 p&amp;lt;0.01). Additionally, there were significantly good positive correlations between the static subscale of TCMS and step length, step wide and symmetry (respectively 0.624; 0.690; 0.720 p&amp;lt;0.01); a good positive correlation between the dynamic subscale of TCMS and step length, good positive correlation between reaching subscale of TCMS and step length; moderate to good positive correlations between total score of TCMS and step length, step wide and gait symmetry (respectively r:-0.872; 0.677; 0.585; 0.626 p&amp;lt;0.01). According to the regression analysis, the total TCMS score was a predictor of all gait characteristics except gait velocity; and mTUG (R2 = 0.796; 0.394; 0.303; 0.027; 0.320). Conclusion: The results of this study show the importance of trunk control on gait characteristics and capacity in children with spastic diplegic CP.

Rehabilitation of Postural Control and Gait in Children with Cerebral Palsy: the Beneficial Effects of Trunk-Focused Postural Activities

ABSTRACT Purpose In children with cerebral palsy (CP), with impaired trunk control and toe-walking, trunk-focused rehabilitation (TFR) based on postural activities was hypothesized to improve trunk postural control, early trunk deceleration, and ankle dorsiflexion braking during walking. Methods: Seventeen children with CP (5–12 years) walking autonomously were randomly assigned to TFR and then usual rehabilitation (TFR-UR) or vice versa (UR-TFR). Results Only after TFR was significant improvements in (i) the Trunk Control Measurement Scale score, postural sway on an unstable sitting device and standing, and (ii) early sternal and sacral decelerations and coupled negative ankle power due to plantar flexors. Conclusion TFR improves trunk dynamics and consequently improves coupled toe-walking.

Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version

The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7-15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach's alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach's alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the "mobility" subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the "feeling about functioning" CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test-retest agreement was found for the total and subscale scores (ICC ≥ 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.

The relationship between the backward walking and proprioception, trunk control, and muscle strength in children with cerebral palsy.

This study was planned to determine the factors affecting backward walking in children with cerebral palsy (CP). The study included 30 children with CP, with a mean age of 10.43 ± 2.76years. Backward walking abilities were evaluated with the 3-Meter Back Walk Test (3MBWT). A digital goniometer was used to evaluate proprioception, the Trunk Control Measurement Scale (TCMS) was used for trunk control, a digital muscle dynamometer was used for muscle strength, and the Gillette Functional Assessment Questionnaire (FAQ) was used for gait evaluation. When the spasticity of children at levels I and II according to the Gross Motor Function Classification System (GMFCS) was compared, a significant difference was found in favor of level I in hamstring, gastro-soleus, and gastrocnemius spasticity (p < 0.05). When the results of the 3MBWT, TCMS, and FAQ were compared, a significant difference was found in favor of level I (p < 0.05). No significant relationship was revealed between the 3MBWT and lower extremity proprioception and TCMS (p > 0.05). A significant negative correlation was observed between the 3MBWT and FAQ (p < 0.05). No significant correlation was found between the 3MBWT and lower extremity muscle strengths (p > 0.05). A significant positive correlation was found only between hip extension proprioception and iliopsoas muscle strength (p = 0.023). There was no significant correlation between the FAQ and lower extremity muscle strength (p > 0.05). It was revealed that the backward walking ability increased as the forward walking function improved in children with CP, but it was not affected by proprioception, trunk control, and muscle strength. NCT05088629 (10/11/2021).

Correlation between trunk control and upper extremity function in subjects with cerebral palsy

Cerebral Palsy (CP) is prevalent disability starting in early childhood characterized as a series of difficulties caused by Central Nervous System lesions. Motor and secondary musculoskeletal problems are seen in CP. The trunk plays an important role in the organization of postural control, balance and also provides free movement of upper limb but in subjects with CP may challenge by manual skills such as fine motor activities and may also have difficulty in maintaining trunk control. : Aim of the study was to assess and investigate the correlation between trunk control and upper limb function in subjects with cerebral palsy. Cross sectional study was conducted in which 34 Subjects from SBB College of physiotherapy, SVP hospital and private clinics were taken. Subjects diagnosed with any clinical type of either gender aged 6 to 15 years CP with Gross Motor Functional Classification System level Ⅱ, Ⅲ, Ⅳ, were included and recent trauma or surgery of upper extremity and spine (less ˂ 6 months) were excluded in the study by convenient sampling. After taken consent, Trunk Control Measurement scale (TCMS) were filled up by primary therapist and ABILHAND kids Gujarati version questionnaires were filled up by parents personal interview. : Data analysis for 34 subjects was done by using SPSS version 16 and Microsoft excels 2019. For data screened nonparametric Spearman correlation co˗ efficient test was used with level of significance kept at 5%. Results showed that there is strong positive correlation between trunk control and upper limb function (r ₌ 0.773 p ₌ 0.05) in subjects with cerebral palsy. Study concluded that Trunk Control is highly correlated with upper limb function in subjects with CP. Therefore, it is important in NeuroRehabilitation applications to improve upper limb function along with control of trunk.

Characteristics of sit-to-stand movement are associated with trunk and lower extremity selective control in children with cerebral palsy: a cross-sectional study.

Even though the effect of several factors on sit-to-stand (STS) performance of children with CP has been previously explored, the potential role of lower extremity selective control, trunk control and sitting function on the performance of STS has not been examined. This study aimed to investigate the association of trunk control and lower extremity selective motor control with STS performance in children with CP. We recruited 28 children with CP aged between 4 and 10 years whose Gross Motor Function Classification System levels were I and II and 32 age-matched typically developing (TP) children. Trunk control, sitting function, selective control of the lower extremities and STS were evaluated with Trunk Control Measurement Scale (TCMS), sitting section of Gross Motor Function Measure-88 (GMFM-88), Selective Control Assessment of the Lower Extremity (SCALE) and the STS outcomes of a force platform [weight transfer time, rising index, and center of gravity (COG) sway velocity], respectively. In all evaluations, children with CP demonstrated lower scores than TD children. A moderate correlation was found between total scores of TCMS, GMFM-88 sitting section scores and COG sway velocity during STS and a fair correlation between SCALE total scores and COG sway velocity in the CP group ( r = -0.51, r = -0.52, r = -0.39, respectively). A fair correlation was found between SCALE total scores and the weight transfer time during STS in children with CP ( r = -0.39). Based on these results, improving trunk and lower extremity selective control may enhance STS performance in children with CP.

Comparison Between Effects of Functional Training Program and Conventional Therapy on Postural Control and Functional Mobility in Chronic Stroke

Objective: To Compare the Effects of Functional Training Program and Conventional Therapy on Postural Control and Functional Mobility in Chronic Stroke Place and duration of Study: This study was conducted in Qureshi Hospital Sahiwal, from September 2019 to March 2020. Methodology: A randomized clinical trial was conducted through non-probability convenient sampling technique in which 12 participants were recruited, randomization was done by Lottery method and participants were divided into 2 groups. Group A received functional training treatment and group B received conventional therapy. Participants of both genders with age 40-65 years were included in study with 6 months of confirmed stroke. Patients with any other neurological disorder or those who were Unable to keep any (Sitting or Standing) position for 30 Second were excluded from the study. Berg balance scale, trunk control measurement scale , 6 Min walk test and time up and go test were used as outcome measuring tools. Pre-treatment and post-treatment readings were taken. And data was analyzed by using SPSS version 21. Results: Mean age and standard deviation of the participants was 48.08±4.833. TUG pre value is 20.25± 2.26 while post treatment value is 15.25±1.14 and pre-value for BBS is 39.75±3.54 while post 48.42±3.2. in 6 MWT pre of the participants was Functional training program improves postural control and functional mobility in chronic stroke patients. Conclusion: It was concluded that functional Training program is better technique to improve patient’s condition as compare to Conventional therapy in TUG and BBS. Both interventions showed non-significant difference on TCMS and 6MWD. Keywords: Functional training program, chronic stroke, Postural control, Functional mobility

Effects of 8 weeks functional training programme on posture control and functional mobility in spastic hemiplegic cerebral palsy.

To determine the impacts of functional training versus conventional training on posture control and functional mobility in spastic hemiplegic cerebral palsy children. The randomised clinical trial was conducted at the Rehab Cure physiotherapy centre, Lahore, Pakistan, from January to September 2020, and comprised children of either gender aged 4-14 years, diagnosed with cerebral palsy, gross motor functional classification system level II or III, and no mental retardation. The subjects were randomised into conventional therapy group A and functional training group B. Intensity of exercises was gradually increased each week, starting from 10 reps to 20 reps. The subjects received treatment 3 times a week for 8 weeks, and each session lasted 45-60 min. Paediatric Balance Scale, Trunk Control Measurement Scale, Five Times Sit to Stand Test and Timed-Up-and-Go test were used at baseline and post-intervention. Data was analysed using SPSS 21. Of the 14 subjects, there were 7(50%) in each of the two groups. Overall, there were 8(57.14%) males and 6(42.86%) females with a mean age of 7.57±1.86 years. Significant improvement was noted in both groups post-intervention (p<0.05), but intergroup differences were not significant (p>0.05). Both functional training and conventional therapy significantly improved postural control and functional mobility in spastic cerebral palsy children, but intergroup differences were not significant. IRCT20200909048676N1.

Effects of modified pilates on trunk, postural control, gait and balance in children with cerebral palsy: a single-blinded randomized controlled study.

This study aimed to determine the effects of modified pilates exercises (MPE) and neurodevelopmental therapy (NDT) on trunk, postural control, gait, and balance in children with cerebral palsy (CP). 18 children with CP between gross motor function classification system (GMFCS) I and III were randomized into two groups as study (Group A, MPE) and control (Group B, NDT). Physiotherapy (PT) took place 2days a week for 8weeks. Trunk control measurement scale (TCMS), seated postural control measurement (SPCM), pediatric reach test (PRT), pediatric berg balance measurement (PBBM), 6 minute walking test (6MWT), observational gait scale (OGS), core stability performance measurements, and muscle strength tests were performed. Mean age of group A (n = 9) was 9 ± 1.58years, and group B (n = 9) was 10 ± 2.73years. Significant differences were found in the SPCM posture (p = 0.000), TCMS (p = 0.004), OGS right (p = 0.019) and left (p = 0.001) scores, abdominal fatigue test (AFT) (p = 0.014), modified side bridge (MSBT) test (right p = 0.04, left p = 0.031), pressure biofeedback unit test (PBU) (p = 0.024), and sit-ups test (SUT) (p = 0.011) in favor of group A. According to the initial measurements of the percentage changes of the tests, significantly difference was found in PBBMR (p = 0.001), PBBML (p = 0.000), SPCM posture (0.001), TCMS (0.000), MBSTET (0.000), MSBT left (p = 0.034), AFT (p = 0.002), PBU (p = 0.015), SUT (p = 0.000), MPUT (p = 0.018), and OGS right (p = 0.029) in favor of group A. The results revealed that MPEs in children with CP positively affects trunk, postural control, gait, and balance compared to NDT. It is concluded that MPE can be used as an alternative treatment approach in children with CP. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION/STUDY START DATE/URL OF THE RECORD: NCT04035954/ 24/07/2019/ August 1, 2019/ https://clinicaltrials.gov/ct2/show/NCT04035954 .

Is photographic posture analysis and trunk control different in hemiparetic and diparetic children with cerebral palsy?

Objective: Photographic posture analysis is a useful, inexpensive, time-efficient, and non-invasive method to assess posture. The primary purpose of this study was to compare PPA and trunk control between children with Diparetic and Hemiparetic Cerebral Palsy (CP). Methods: Fifty-two children with hemiparetic and diparetic CP whose GMFCS levels I and II were compared with PPA in sitting position and also trunk control was measured with Trunk Control Measurement Scale (TCMS). Results: There was no scientific difference in craniovertebral angle, sagittal head tilt, sagittal shoulder-C7 angle, thoracic kyphosis angle, coronal head tilt, coronal shoulder angle, coronal pelvic angle in PPA and TCMS between groups (p&gt;0.05), however, there was a scientific difference in lumbar lordosis angle in PPA between the groups (p&lt;0.05). Conclusion: Lumbar lordosis is more common in children with hemiparetic CP than diparetic CP. It can be thought that this situation requires children to change their body biomechanics to compensate their affected sides more than the children with diparetic CP. The physicians should take care of the postural alignment of the lumbar and pelvic girdle of hemiparetic CP. We think that muscle strength, muscle shortness, and other lower extremity biomechanics that could increase lordosis should be examined in detail in hemiparetic CP regardless of where the origin of lumbar lordosis (pelvis or lumbar region).

The Function Assessment Scale for Spinal Deformity: Validity and Reliability of a New Clinical Scale.

Cross-sectional study. The aim of this study was to develop and validate the Function Assessment scale for Spinal Deformity (FASD). Spinal malalignment impacts daily functioning. Standard evaluation of adult spinal deformity (ASD) is based on static radiography and patient-reported scores, which fail to assess functional impairments. A clinical scale, quantifying function and balance of patients with ASD, could increase our insights on the impact of ASD on functioning. To develop the FASD, 70 ASD patients and 20 controls were measured to identify the most discriminating items of the Balance Evaluation Systems Test and Trunk Control Measurement Scale. Discussions between experts on the clinical relevance of selected items led to further item reduction. The FASD's discriminative ability was established between 43 patients and 19 controls, as well as between three deformity subgroups. For its responsiveness to treatment, 10 patients were reevaluated 6 months postoperatively. Concurrent validity was assessed through correlation analysis with radiographic parameters (pelvic tilt; sagittal vertical axis [SVA]; pelvic incidence minus lumbar lordosis [PI-LL]; coronal vertical axis) and patient-reported scores [Oswestry Disability Index]; Scoliosis Research Society outcome questionnaire; Falls Efficacy Scale-International). Test-retest and interrater reliability were tested on two groups of ten patients using intraclass correlation coefficients (ICC). Patients with ASD, mainly with sagittal malalignment, scored worse compared to controls on FASD (P < 0.001) and its subscales. No significant improvement was observed 6 months postoperatively (P = 0.758). FASD correlated significantly to all patient-reported scores and to SVA and PI-LL. Reliability between sessions (ICC = 0.97) and raters (ICC = 0.93) was excellent. Subscales also showed good to excellent reliability, except FASD 1 on "spinal mobility and balance" between sessions (ICC = 0.71). FASD proved to be a valid and reliable clinical scale for evaluation of functional impairments in ASD. Objective information on function and balance might ultimately guide physiotherapeutic treatment toward improved functioning.Level of Evidence: 2.

The effect of trunk training on trunk control, upper extremity, and pulmonary function in children with Duchenne muscular dystrophy: A randomized clinical trial

Objectives: To investigate the effect of trunk training on trunk control, arm, and pulmonary function in children with Duchenne muscular dystrophy. Design: A randomised controlled trial. Settings: Neuromuscular diseases clinic of university hospital. Subjects: Twenty-six children with Duchenne muscular dystrophy aged 5–16 were included in the study. Intervention: Participants were randomly allocated into two groups. The study group (N = 13) exercised with the trunk-oriented exercise program and the conventional exercise program, whereas the control group (N = 13) underwent the conventional exercise program for eight weeks. Main measures: The primary outcomes were trunk control was assessed using the Trunk Control Measurement Scale, the arm function was assessed using Performance of Upper Limb, and respiratory function using the pulmonary function test. Data collection was conducted at baseline, and eighth week. The differences in trunk control scores, arm function scores, and respiratory function values before and after the training were calculated for the intergroup comparison. Results: The mean age of the participants was 11.6 (2.6) in the study group and 10.6 (3.4) in the control group. The changes between trunk control score, arm function score (total and distal level score), and respiratory function value (Forced Vital Capacity, Forced Expiratory Volume in one second, and Peak Expiratory Flow Volume percentage values) were compared and significant differences were found after eight week periods in the study and control groups. Conclusions: Trunk-oriented exercise program in Duchenne muscular dystrophy might be effective for trunk control, arm, and respiratory function.