Core Stabilization for Upper Extremity Function and Balance in Children With Cerebral Palsy

The Effect of Core Stabilization Exercises on Upper Extremity Function and Balance in Children With Cerebral Palsy: A Randomized Controlled Trial

This study investigates the effects of core stabilization exercises on balance and upper extremity function in children with cerebral palsy (CP). A total of 36 children aged 5 to 12 years with CP were randomly assigned to either an intervention group or a control group. Both groups received standard physiotherapy, rehabilitation, and occupational therapy five days a week for four weeks. In addition, the intervention group performed daily core stabilization exercises for approximately 45 minutes. The study assessed balance using the Pediatric Berg Balance Scale and the Trunk Control Measurement Scale, and upper extremity function using the Box and Block Test and the Assisting Hand Assessment before and after the treatment period.

Cerebral palsy (CP) is a group of permanent disorders of movement and posture that occur due to non-progressive disturbances in the developing fetal or infant brain. Children with CP often experience deficits in trunk control, balance, and upper extremity function, which significantly affect their daily activities and quality of life. Core stabilization exercises are widely used in neurorehabilitation to improve trunk control and postural stability, potentially enhancing balance and upper limb function.

This randomized controlled trial aimed to evaluate the effects of core stabilization exercises on upper extremity function and balance in children with CP. The study included children aged 5 to 12 years, classified at levels I-III according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS), and with spasticity levels ≤2 according to the Modified Ashworth Scale (MAS). Participants were randomly assigned to either an intervention or a control group. Both groups received a standardized physiotherapy and occupational therapy program five days a week for four weeks. In addition to the standard care, the intervention group performed daily 45-minute sessions of core stabilization exercises.

Outcome measures included the Pediatric Berg Balance Scale (PBBS) and the Trunk Control Measurement Scale (TCMS) for evaluating balance, and the Box and Block Test (BBT) and the Assisting Hand Assessment (AHA) for assessing upper extremity function. Assessments were conducted at baseline and post-intervention. The study hypothesized that children receiving core stabilization exercises in addition to standard therapy would show greater improvements in balance and upper extremity function compared to those receiving standard therapy alone.

Inclusion Criteria: Who had no other medical conditions that could affect the evaluation and had not had surgery in the past six months.

Exclusion Criteria: Children with severe intellectual disability, muscle contractures or bone deformities, visual impairments, uncontrolled seizures, other neuromuscular diseases, spinocerebellar ataxia, autism spectrum disorder, or communication disorders, as well as children diagnosed with hyperactivity and attention deficit disorder, were excluded from the evaluation. Patients classified as level IV or V according to the Gross Motor Function Classification System (GMFCS), with a spasticity level of 3 or higher according to the Modified Ashworth Scale (MAS), and classified as level IV or V according to the Manual Ability Classification System (MACS) were not included in the study. -