effects of trunk-focused rehabilitation on spinal mobility, trunk control, and hand functions in cerebral palsy

Conditions: Cerebral Palsy (CP); Adolescent; Trunk; Exercise

Summary: main purpose: this study aims to investigate the effects of trunk-focused rehabilitation on trunk control, spinal mobility, and manual skills in adolescents with cerebral palsy (cp). secondary purpose: to investigate its effects on functional health.

muscle weakness in the trunk; reducing the support of children with cp, may cause increased distal tone and decreased function in their daily practices. when the effectiveness of interventions that can improve postural control is evaluated, trunk-focused training is one of the 5 interventions supported by a moderate level of evidence. in an intervention study where trunk training was structured individually, there may be an improvement in erector spinae muscle group scores when evaluated with semg. a study of 28 cases, including all subtypes of cp, aimed to evaluate the inter-rater reliability of spinal mouse (sm) and the effect on the spinal column with 4 hours a day, 1 week of intensive clinical rehabilitation application. in this population, sm was evaluated with therapeutic interventions, it has been reported that it may show significant posture differences, especially in total spinal inclination and spine length. in children aged 5-12 years with gross motor function classification system (gmfcs) level 1, 2 cp, there are significant improvements in the trunk control measurement scale (tcms) score after only trunk focused rehabilitation (tfr). it is emphasized that with tfr, which is described as a unique approach, postural control of the whole body can be improved by the use of intermediate postures and postural activities involving the trunk and better participation of the affected muscles. only after tfr intervention, the findings of improvement in the assessments on a 3d force platform were highlighted in postural sway, early sternal and sacral decelerations. it is carried out with active participation, individualized, intensive, and time-limited, considering possible content limitations and the needs and preferences of the adolescent and the family. it is stated that trunk-targeted interventions can be given together with conventional physical therapy programs to support functional improvements.

Eligibility criteria:
inclusion criteria: 1. levels 1 and 2 according to gross motor function classification system (gmfcs) 2. viking speech scale turkish version/(vss-t) 1-2 level, understood to speak and able to take commands 3. adolescents with cp between the ages of 12-18 4. those whose guardian / legal representative and themselves have received an informed voluntary consent form 5. no hip dislocation 6. scoliosis below 25 degrees according to the radiographic evaluation made in the last 6 months exclusion criteria: 1. having had any surgery related to the intrathecal baclofen pump 2. having botulinum toxin injection treatment or orthopedic surgery within the last 6 months 3. having severe vision, hearing, and cognitive deficiencies 4. acute medical illness

Keywords: cerebral palsy, trunk training, trunk control exercise