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Trunk Control Balance and Upper Extremity Function in Ambulatory Children with Diplegic Cerebral Palsy: A Comparative
Burcin Ugur Tosun1, Ozge Gokalp2, Gulhan Yilmaz Gokmen3
1Department of Physical Therapy and Rehabilitation, Eastern Mediterranean University, Famagusta, Turkey, burcnugur@yahoo.com.
Introduction:
This study aimed to investigate trunk control, balance, and upper extremity skill quality in ambulatory children with diplegic cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS)-I and -II, as well as to compare the GMFCS groups among themselves and with healthy children.
Methods:
Twenty-five children with spastic diplegic CP (11.80 ± 2.66 years) and 30 healthy children (13.57 ± 3.48 years) were included. Functional levels were classified with the GMFCS, with 13 children classified as GMFCS-I and 12 as GMFCS-II, while trunk control was assessed with the Trunk Control Measurement Scale (TCMS), balance with the Single-Leg Stance and Four-Square Step Tests, and upper extremity functionality with the Quality of Upper Extremity Skills Test (QUEST).
Results:
There was no significant difference in age, body mass index, or gender distribution between the CP and control groups (p > 0.05). The healthy group outperformed both CP groups in all clinical evaluations. No significant differences were found between GMFCS-I and GMFCS-II groups in the Single-Leg Stance Test, Four-Square Step Test, and QUEST parameters (p > 0.05). However, TCMS subdomains static sitting (p = 0.009), dynamic reaching (p = 0.018), selective movement control (p = 0.012), and total scores (p = 0.006) were significantly higher in the GMFCS-I group. A moderate positive correlation and a 54% regression rate were observed between the QUEST and TCMS scores.
Conclusion:
Trunk control is a key determinant of upper extremity skill quality in children with CP. Core stabilization should be prioritized to improve upper extremity functionality and manage disability levels effectively.
