Standard home based exercise program

Performance assessment is conducted by recording the maximum time the individual can maintain the test position. Before each test, the child is asked to maintain the test position for as long as possible. Each test will be repeated three times, and the average time will be recorded. To minimize the risk of injury or psychological distress, the tests will be explained in detail to the children beforehand, and their administration will be demonstrated. Two healthcare professionals will be present during each test to ensure the child maintains proper form and ensure safety.

Back extension test: Biering-Sørensen position with trunk held horizontal, pelvis/legs strapped; ended at loss of position or 300s.

Lateral torso test: Full side-bridge with straight body on elbow; stopped when posture broke or 300s.

Flexor test: Sit-up at 50° support, arms crossed, feet secured; ended when back touched support or 300s.

It is a measurement method that evaluates the dynamic component of balance. The test will be conducted by measuring the distance in centimeters that participants can reach forward, then to the right and left, without lifting their heels while standing upright. The procedures will be explained to participants once, and then they will be asked to perform the exercise three times. They will be expected to hold each position for at least 3 seconds. Measurements where participants lose their balance and lift their feet off the ground will be invalid. The distance reached will be measured in centimeters using a non-stretchable tape measure.

The test consists of two sections: sitting and standing, with three items in each section (six items in total). The total score is calculated by measuring the distance in centimeters between the starting position (shoulder flexed 90° for forward reach and shoulder abducted 90° for side reach) and the maximum stable reach.

The WeeFIM is used to measure functional independence in activities of daily living for children aged 6 months to 12 years. It consists of 18 items covering self-care, toilet control, mobility, locomotion, communication, and social development.

A 7-level ordinal rating system ranging from 7 (complete independence) to 1 (total assistance), is used to score performance in each item. As with the FIM, the Wee- FIM consists of two dimensions: motor and cognitive.

The WeeFIM is a reliable and valid tool for assessing the functional status of children with CP.

The PEDQoL 4.0 Pediatric Quality of Life Questionnaire will be used. Depending on the participant's age, the child report and parent report forms will be used for children aged 7 and 8, and the child report and parent report forms for children aged 8-12. It is designed to measure core health dimensions defined by the World Health Organization (WHO). It is administered in parallel in child self-report and parent proxy report formats. The participant is asked how much of a problem each item has been in the past month.

Participants are asked to rate how problematic each item has been during the past month. Reverse scoring is applied and converted to a 0-100 scale: 0 = 100 points, 1 = 75 points, 2 = 50 points, 3 = 25 points, and 4 = 0 points. The total scale score is calculated by dividing the sum of responses by the number of items answered. If more than 50% of the items are missing, the scale score is not computed.

Activity and Participation Assessment: Will be evaluated with the Brief ICF Core Set for Children and Adolescents with CP (≥6, <14 Years). Difficulty levels will be evaluated using the ICF Qualifiers. A score of 0 indicates no difficulty (0-4%), 1 mild difficulty (5-24%), 2 moderate difficulty (25-49%), 3 severe difficulty (50-95%), and 4 complete difficulty (96-100%). Scores 8 ("not specified") and 9 ("not applicable") are used when relevant.

Activity and participation will be assessed under the domains of performance and capacity. Higher scores in each parameter indicate greater limitation.