- Original article
- Open Access
Impact of core stability education on postural control in children with spastic cerebral palsy
Bulletin of Faculty of Physical Therapy volume 24, pages 85–89 (2019)
Postural control includes controlling the body’s position in space to achieve stability and orientation. Core stability education is applied to teach children to improve balance and postural control.
The objective of this study was to detect the impact of core stability education on postural control in children with spastic cerebral palsy (CP).
Patients and methods
Thirty spastic CP children (6–8 years) received intervention in the outpatient clinic of Faculty of Physical Therapy, Cairo University.
The participants were randomly divided into a control group and a study group; the control group received selective therapeutic exercises, while the study group received the same selective program in addition to core stability exercises three times/week for 60 min for 12 weeks.
Main outcome measures
Dynamic balance was assessed by Biodex Balance System before and after treatment (12 weeks).
There was a significant improvement of all stability indices (anteroposterior, mediolateral, and overall) in each group. There was more improvement in the study group when comparing post-treatment values of both groups (P<0.05).
According to the results of the current study, core stability program is highly recommended to be included in the treatment program of spastic CP children to improve balance.
Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 2005; 47:571–576.
Shepherd R. Cerebral palsy. In: Shepherd R, ed. Physiotherapy in pediatrics. Oxford: Butterworth-Heinemann 1995. 110–144
Styer-Acevedo J. Physical therapy for the child with cerebral palsy. In: Jan S. Tecklin. Pediatric physical therapy. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins 1999.
Seymour R. Prosthetics and orthotics: lower limb and spine. Philadelphia, PA: Lippincott Williams & Wilkins 2002. 367–426
Koman LA, Smith BP, Shilt JS. Cerebral palsy. Lancet 2004; 363:1619–1631.
Shumway-Cook A, Woollacott MH. Motor control. theory and practical application. 2nd ed. Philadelphia, PA: J. B. Lippincott 2001.
Wade L, Canning C, Fowler K, Flemingham K, Baguley I. Changes in postural sway and performance of functional tasks during rehabilitation after traumatic brain injury. Arch Phys Med Rehabil 1997; 78:1107–1111.
Briggs A, Greig A, Wark J, Fazzalari N, Bennell K. A review of anatomical and mechanical factors affecting vertebral body integrity. Int J Med Sci 2004; 1:170–180.
Liemohn WP, Baumgartner TA, Gagnon LH. Measuring core stability. J Strength Cond Res 2005; 19:583–586.
Cowley P, Swensen T. Development and reliability of two core stability field tests. J Strength Cond Res 2008; 22:619–624.
Zazulak B, Hewett T, Reeves N, Goldberg B, Cholewicki J. The effects of core proprioception on knee injuries: a prospective biomechanical epidemiological study. Am J Sports Med 2007; 35:368–373.
Wiley ME, Damiano DL. Lower-extremity strength profiles in spastic cerebral palsy. Dev Med Child Neurol 1998; 40:100–107.
Ju Y, Hwang I, Cherng R. Postural adjustment of children with spastic diplegic cerebral palsy during seated hand reaching in different directions, Arch Phys Med Rehabil 2012; 93:471–479.
Bohannon RW, Smith MB. Inter-reliability of modified ashworth scale of muscle spasticity. Phy Ther 1987; 67:206–207.
Fredericson M, Moore T. Muscular balance, core stability, and injury prevention for middle- and long-distance runners. Phys Med Rehabil Clin N Am 2005; 16:669–689.
Lahatinen U, Rintala P, Malin A. Physical performance of individuals with intellectual disability: a30-year followup. Adapt Phys Activ Q 2007;14:125–143.
Veerle KS, Andry V, Katie GB, Nele NM, Guy GV, Lieven AD. Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers. Eur Spine J 2007; 16:711–718.
Bobath K. A neurophysiological basis for the treatment of cerebral palsy. London: Spastics International Medical Publications: William Heinemann Medical Books; Philadelphia : Lippincott; 1980
Ayres AJ. Sensory integration and learning disorders. Los Angeles: Western Psychological Service; 1972.
Gracies J, Burke K, Clegg N, Browne R, Rushing C, Fehlings D, Delgado MR. Reliability of the tardieu scale for assessing spasticity in children with cerebral palsy. Arch Phys Med Rehabil 2010; 91:421–428.
Unayik M, Kahiyan H. Down syndrome: sensory integeration, vestibular stimulation and neurodevelopmental therapy approaches for children?. In Stone JH, Blouin M eds. International encyclopedia of rehabilitation. Turkey: The Center for International Rehabilitation Research Information and Exchange (CIRRIE) 2011.
Chow JW, Shim JH, Lim YT. Lower trunk muscle activity during the tennis serves. J Sci Med Sport 2003; 6:512–518.
Rose J, Wolff DR, Jones VK, Bloch DA, Oehlert JW, Gamble JG. Postural balance in children with cerebral palsy. Dev Med Child Neurol 2011; 44:58–63.
Carr , Shepherd R. Physical therapy in pediatrics. 3rd ed. Heinemann, Oxford: Butter Worth 2011. 51–53
Niam S, Anderson W. Balance and physical impairments after stroke. Arch Phys Med Rehabil 2010; 80:1227–1233.
Saggini R, Vecchiet J, Iezzi S, Racciatti D, Affaitati G, Bellomo RG, Pizzigallo E. Submaximal aerobic exercise with mechanical vibrations improves the functional status of patients with chronic fatigue syndrome. Eura Medicophys 2006; 42:97–102.
Dodd K, Taylor N, Damiano D. Systemic review of strengthening for individuals with cerebral palsy. Arch PhysMed Rehabil 2012; 83:1157–1164.
Gillen G. Trunk control: a prerequisite for functional independence: a function based approach. St Louis: Mosby 2013. 69–89
Park E, Park C, Lee H, Cho Y. The effect of electrical stimulation of the trunk control in young children with spastic diplegic cerebral palsy. J Korean Med Sci 2001; 16:347–350.
Hartbourne R, Willett S, Kyvelidou A, Deffeyes J, Stergiou N. A comparison of interventions for children with cerebral palsy to improve sitting postural control: a clinical trial. Phys Ther 2010; 90:1881–1889.
Sterba J, Rogers B, France A, Vokes D. Horseback riding in children with cerebral palsy, effect on gross motor function. Dev Med Child Neurol 2002; 8:301.
Visintin M, Chakrabarty S, Martin J. The effect of body weight support on the locomotor pattern of spastic paretic patients. Can J Neuro Sci 1989; 16:315–325.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
About this article
Cite this article
Ali, M. Impact of core stability education on postural control in children with spastic cerebral palsy. Bull Fac Phys Ther 24, 85–89 (2019). https://doi.org/10.4103/bfpt.bfpt_25_18
- cerebral palsy
- core stability education
- postural control