Effects of Modified Pilates Exercises on Body Control, Gait and Function in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      Children with cerebral palsy (CP) have limitations in postural reactions and antigravity
      movements. Trunk control is the determinant of posture, balance, walking and functional
      activities. Core stability connects deep abdominal muscles, spine, pelvis, and shoulder
      girdle to protect the posture and provides support for extremity movements. Pilates and core
      stabilization were associated with postural control in elderly, MS and stroke individuals and
      it was concluded that pilates caused an increase in trunk stabilization. There are not enough
      studies investigating the effectiveness of pilates exercises in CP. The aim of this study was
      to investigate the effects of modified pilates exercises on body control, gait and
      functionality in children with CP.
    

Detailed description: 
      Postural control is the ability of the body to control its position in space for stability
      and orientation. Postural stability and balance are achieved by keeping the center of gravity
      of the body within the support surface. Stability can also occur with a static response when
      the body is stationary, and a dynamic response to internal or external perturbations when it
      is mobile. Antisipation of perturbation forces requires an effective core stabilization
      muscle activation as well as an effective integration of stimuli from different sensory
      systems. Trunk control is also provided by this relationship between neural systems and
      skeletal muscles. Children with CP show deficits in proximal muscle co-contraction and
      vertical posture stabilization, with limitations in postural reactions and antigravity
      movements. Trunk control is the determinant of balance, gait and functional activities from
      the early period. Core stability; it connects with deep abdominal muscles, spine, pelvis and
      shoulder girdle muscles to protect the posture and provide support for limb movement. During
      reaching out, stepping and sudden perturbations, the Transversus Abdominus muscle is
      activated primarily from other trunk and limb muscles, creating a core stability. Core
      activity includes not only spinal stability and power generation, but also many upper and
      lower extremity movements. Control is established by focusing on the transversus abdominis
      muscle by core stabilization training with Pilates, stabilization of trunk muscles. The
      proximal extremity muscles of the hip are also important to maintain the upright posture and
      maintain mobility. For example; hip abductor muscle strength compared to the knee and ankle
      muscles, walking variables and motor functions in children with CP were more correlated.
      Although the importance of walking was determined, activation patterns of trunk and hip
      muscles during walking were examined in a limited number of studies in individuals with CP.
      The effects of pilates on healthy adults, elderly, multiple sclerosis, stroke and
      musculoskeletal disorders were investigated and resulted in increased trunk
      stabilization.Therefore, it is thought that pilates can be applied in terms of muscle
      strength and postural control in children who can walk, stand independently, but need to
      develop some components for controlled movement. There are not enough studies investigating
      the effectiveness of pilates exercises in CP. The aim of this study was to investigate the
      effects of modified pilates exercises on body control, gait and function in children with CP.
    

Intervention name(s): exercise
Intervention type(s): Other
Intervention description(s): The control group will continue the routine NDT: Neurodevelopmental Therapy-based physiotherapy program twice a week. The treatment group will participate in clinical pilates exercises for 2 hours / day for 1 hour / 8 weeks. They will also continue their weekly routine physiotherapy programs.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study will include16 children with cerebral palsy (SP) diagnosed at the GMFCS I-II-III level with 8 controls and 8 treatment groups by random minimization between 7-14 years of age with 1 and 1+ spasticity on the lower extremity according to the Modified Ashworth Score.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cerebral Palsy; modified pilates; trunk; gait; function; core stability