Effects Of Individually Structured Trunk Training On Body Function And Structures In Children With Spastic Cerebral Palsy: A Stratified Randomized Controlled Trial

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.