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Effect of trunk belt on function in children with diplegia


Background and purpose

Trunk control can offer many solutions for posture and movement. The purpose of this study was to determine the effect of using modified trunk belt on sitting and standing in diplegic children.

Patients and methods

Thirty diplegic cerebral palsy children from both sexes participated. Their ages ranged from 3 to 6 years. They were divided randomly into two groups: control and study. The control group received a designed physical therapy program, and the study group received a designed physical therapy program in addition to proprioceptive training using a modified trunk belt. The sitting and standing domains were evaluated using the Gross Motor Function Measure for both groups before and after 3 successive months of treatment.


The Wilcoxon test revealed that the gross motor function of children from both groups improved significantly after 3 months of treatment in both the sitting and standing domains. The Mann–Whitney test revealed that children in the study group showed a significantly greater improvement in both domains compared with the control group.


Proprioceptive training using trunk belt with physical therapy program could be used as an effective method for improving gross motor function of both sitting and standing in children with diplegia.


  1. 1

    Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109:8–14.

    PubMed  PubMed Central  Google Scholar 

  2. 2

    Braendvik SM, Elvrum AK, Vereijken B, Roeleveld K. Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy. Dev Med Child Neurol 2010; 52: 29–34.

    Article  Google Scholar 

  3. 3

    Latash M, Hadders-Algra M. What is posture and how is it controlled? In: Algra MH, Carlberg EB, editors. Postural control: a key issue in developmental disorders. London, UK: Mac Keith Press; 2008. 3–21.

    Google Scholar 

  4. 4

    Tang-Wai R, Webster RI, Shevell MI. A clinical and etiologic profile of spastic diplegia. Pediatr Neurol 2006; 34:212–218.

    Article  Google Scholar 

  5. 5

    Graham HK. The managements of spastic diplegia. Curr Orthop 2003; 17:88–104.

    Article  Google Scholar 

  6. 6

    Park ES, Park CI, Lee HJ, Cho YS. The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy. J Korean Med Sci 2001; 16:347–350.

    CAS  Article  Google Scholar 

  7. 7

    Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil 2006; 20:451–458.

    Article  Google Scholar 

  8. 8

    Huang QM, Hodges PW, Thorstensson A. Postural control of the trunk in response to lateral support surface translations during trunk movement and loading. Exp Brain Res 2001; 141:552–559.

    CAS  Article  Google Scholar 

  9. 9

    Lin SI, Woollacott MH, Jensen JL. Postural response in older adults with different levels of functional balance capacity. Aging Clin Exp Res 2004; 16:369–374.

    Article  Google Scholar 

  10. 10

    Liao HF, Hwang AW. Relations of balance function and gross motor ability for children with cerebral palsy. Percept Mot Skills 2003; 96(Pt 2): 1173–1184.

    Article  Google Scholar 

  11. 11

    Bohannon R, Smith MB. Inter-reliability of modified Ashwerth scale of muscle spasticity. Phys Ther 1987; 67:206–208.

    CAS  Article  Google Scholar 

  12. 12

    Russell DJ, Avery LM, Walter SD, Hanna SE, Bartlett DJ, Rosenbaum PL, et al. Development and validation of item sets to improve efficiency of administration of the 66-item Gross Motor Function Measure in children with cerebral palsy. Dev Med Child Neurol 2010; 52:48–54.

    Article  Google Scholar 

  13. 13

    Brunton LK, Bartlett DJ. Validity and reliability of two abbreviated versions of the Gross Motor Function Measure. Phys Ther 2011; 91:577–588.

    Article  Google Scholar 

  14. 14

    Ko J, Kim M. Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy. Phys Ther 2013; 93:393–400.

    Article  Google Scholar 

  15. 15

    Russell DJ, Rosenbaum PL, Wright M, Avery LM. Gross motor function measure (GMFM-66 and GMFM-88):user’s manual. London, UK: MacKeith Press; 2013.

    Google Scholar 

  16. 16

    Damiano DL, Kelly LE, Vaughn CL. Effect of quadriceps femoris muscle strengthening on crouch gait in children with spastic diplegic. Phys Ther 1995; 75:658–667.

    CAS  Article  Google Scholar 

  17. 17

    Burtner PA, Woollacott MH, Craft GL, Roncesvalles MN. The capacity to adapt to changing balance threats: a comparison of children with cerebral palsy and typically developing children. Dev Neurorehabil 2007; 10:249–260.

    CAS  Article  Google Scholar 

  18. 18

    Edin B. Cutaneous afferents provide information about knee joint movements in humans. J Physiol 2001; 531(Pt 1): 289–297.

    CAS  Article  Google Scholar 

  19. 19

    Dietz V. Proprioception and locomotor disorders. Nat Rev Neurosci 2002; 3:781–790.

    CAS  Article  Google Scholar 

  20. 20

    Koscielny R. Strength training and cerebral palsy. Cerebral Palsy Magazine 2004; 2:12–14.

    Google Scholar 

  21. 21

    Dodd KJ, Taylor NF, Graham HK. A randomized clinical trial of strength training in young people with cerebral palsy. Dev Med Child Neurol 2003; 45:652–657.

    Article  Google Scholar 

  22. 22

    Ahmed MA, Abd El Azeim FH, Abd El Raouf EG. The problem solving strategy of poor core stability in children with cerebral palsy: a clinical trial. J Pediatr Neonat Care 2014; 1:00037.

    Google Scholar 

  23. 23

    Verheyden G, Nieuwboer A, de Wit L, Feys H, Schuback B, Baert I, et al. Trunk performance after stroke: an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry 2007; 78: 694–698.

    Article  Google Scholar 

  24. 24

    Mudie MH, Winzeler-Mercay U, Radwan S, Lee L. Training symmetry of weight distribution after stroke: a randomized controlled pilot study comparing task-related reach, Bobath and feedback training approaches. Clin Rehabil 2002; 16:582–592.

    CAS  Article  Google Scholar 

  25. 25

    Batra M, Sharma VP, Malik GK, Batra V, Agarwal GG. Intervention based on dynamics of postural control in children with cerebral palsy –an integral approach. Indian J Physiother Occup Ther 2010; 5: 68–73.

    Google Scholar 

  26. 26

    Frankenburg M. Motor development. In: Snow CW, editor. Infant development. 2nd ed. NJ, USA: Prentice Hall; 2004: 152.

    Google Scholar 

  27. 27

    Youssr HM, Abdel-aziem AA. Effect of trunk exercises on trunk control, balance and mobility function in children with hemiparetic cerebral palsy. Int J Ther Rehabil Res 2015; 4:236–243.

    Google Scholar 

  28. 28

    Karthikbabu S, Rao BK, Manikandan N, Solomom JM, Chakrapani M. Role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke, a pre post design. Neurosci Med 2011; 2:61–67.

    Article  Google Scholar 

  29. 29

    Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol 2003; 45:591–602.

    Article  Google Scholar 

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Corresponding author

Correspondence to Nanees E. Mohamed PhD.

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Wahsh, H.A., Shoukry, K.E. & Mohamed, N.E. Effect of trunk belt on function in children with diplegia. Bull Fac Phys Ther 21, 68–73 (2016).

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  • cerebral palsy diplegia
  • gross motor function
  • proprioceptive training
  • trunk control