Comparison of the Effectiveness of Different Trunk-Focused Exercise Approaches for Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial

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Abstract
Purpose : This study compared the effects of Neuro-Developmental Treatment-based trunk training, video game-based trunk training (VG-TT), and VG-TT with an orthotic garment in children with unilateral cerebral palsy. Methods : Forty-two children with unilateral cerebral palsy received usual physiotherapy (2 d/wk) for 8 weeks (control period). They were then randomized to 8 weeks of Neuro-Developmental Treatment-based trunk training, VG-TT, or VG-TT with an orthotic garment (2 d/wk) alongside usual physiotherapy (intervention period). Primary outcomes were the Trunk Control Measurement Scale and Becure Balance Assessment System. Secondary outcomes included the Pediatric Berg Balance Scale and Gillette Functional Assessment Questionnaire. Results : No significant improvements in trunk control were observed during the control period ( P > .05), and all groups showed significant gains during the intervention period ( P < .05). Functional and sitting balance improved in all groups throughout both periods ( P < .05). However, no significant differences were found between intervention groups in trunk control, sitting balance, balance, or walking function ( P > .05). Discussion : Trunk-specific training enhances trunk control and functional balance in children with unilateral cerebral palsy. As no approach proved superior, interventions can be tailored based on individual needs and clinical context.

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