Skip to main content

Impact of core stability education on postural control in children with spastic cerebral palsy

Abstract

Background

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.

Objective

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.

Intervention

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).

Results

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).

Conclusion

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.

References

  1. 1

    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.

    Article  Google Scholar 

  2. 2

    Shepherd R. Cerebral palsy. In: Shepherd R, ed. Physiotherapy in pediatrics. Oxford: Butterworth-Heinemann 1995. 110–144

    Google Scholar 

  3. 3

    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.

    Google Scholar 

  4. 4

    Seymour R. Prosthetics and orthotics: lower limb and spine. Philadelphia, PA: Lippincott Williams & Wilkins 2002. 367–426

    Google Scholar 

  5. 5

    Koman LA, Smith BP, Shilt JS. Cerebral palsy. Lancet 2004; 363:1619–1631.

    Article  Google Scholar 

  6. 6

    Shumway-Cook A, Woollacott MH. Motor control. theory and practical application. 2nd ed. Philadelphia, PA: J. B. Lippincott 2001.

    Google Scholar 

  7. 7

    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.

    CAS  Article  Google Scholar 

  8. 8

    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.

    Article  Google Scholar 

  9. 9

    Liemohn WP, Baumgartner TA, Gagnon LH. Measuring core stability. J Strength Cond Res 2005; 19:583–586.

    PubMed  Google Scholar 

  10. 10

    Cowley P, Swensen T. Development and reliability of two core stability field tests. J Strength Cond Res 2008; 22:619–624.

    Article  Google Scholar 

  11. 11

    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.

    Article  Google Scholar 

  12. 12

    Wiley ME, Damiano DL. Lower-extremity strength profiles in spastic cerebral palsy. Dev Med Child Neurol 1998; 40:100–107.

    CAS  Article  Google Scholar 

  13. 13

    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.

    Article  Google Scholar 

  14. 14

    Bohannon RW, Smith MB. Inter-reliability of modified ashworth scale of muscle spasticity. Phy Ther 1987; 67:206–207.

    CAS  Article  Google Scholar 

  15. 15

    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.

    Article  Google Scholar 

  16. 16

    Lahatinen U, Rintala P, Malin A. Physical performance of individuals with intellectual disability: a30-year followup. Adapt Phys Activ Q 2007;14:125–143.

    Article  Google Scholar 

  17. 17

    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.

    Article  Google Scholar 

  18. 18

    Bobath K. A neurophysiological basis for the treatment of cerebral palsy. London: Spastics International Medical Publications: William Heinemann Medical Books; Philadelphia : Lippincott; 1980

    Google Scholar 

  19. 19

    Ayres AJ. Sensory integration and learning disorders. Los Angeles: Western Psychological Service; 1972.

    Google Scholar 

  20. 20

    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.

    Article  Google Scholar 

  21. 21

    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.

    Google Scholar 

  22. 22

    Chow JW, Shim JH, Lim YT. Lower trunk muscle activity during the tennis serves. J Sci Med Sport 2003; 6:512–518.

    CAS  Article  Google Scholar 

  23. 23

    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.

    Article  Google Scholar 

  24. 24

    Carr , Shepherd R. Physical therapy in pediatrics. 3rd ed. Heinemann, Oxford: Butter Worth 2011. 51–53

    Google Scholar 

  25. 25

    Niam S, Anderson W. Balance and physical impairments after stroke. Arch Phys Med Rehabil 2010; 80:1227–1233.

    Article  Google Scholar 

  26. 26

    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.

    CAS  PubMed  Google Scholar 

  27. 27

    Dodd K, Taylor N, Damiano D. Systemic review of strengthening for individuals with cerebral palsy. Arch PhysMed Rehabil 2012; 83:1157–1164.

    Article  Google Scholar 

  28. 28

    Gillen G. Trunk control: a prerequisite for functional independence: a function based approach. St Louis: Mosby 2013. 69–89

    Google Scholar 

  29. 29

    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.

    CAS  Article  Google Scholar 

  30. 30

    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.

    Article  Google Scholar 

  31. 31

    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.

    Google Scholar 

  32. 32

    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.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Mostafa S. Ali.

Additional information

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.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

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

Download citation

Keywords

  • cerebral palsy
  • children
  • core stability education
  • postural control