Assessment of trunk movement and posture in spastic and dyskinetic cerebral palsy: A scoping review

To map and summarize available clinical and instrumented assessment tools for evaluating trunk control in individuals with spastic or dyskinetic cerebral palsy (CP) across Gross Motor Function Classification System (GMFCS) levels, describing their current application, assessed features, and psychometric properties, to provide first practical guidance for tool use.

For this scoping review, eight databases were systematically searched. Studies were included if they evaluated reliability, validity, or responsiveness of tools assessing trunk control in spastic/dyskinetic CP. The review followed the methodology of the JBI and the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR).

The search yielded 27 332 publications, of which 110 met the inclusion criteria. Twenty-two distinct assessment tools were identified, including 12 clinical and 10 instrumented. Instrumented assessment tools were most frequently investigated (65%). Validity was reported in 62% of studies; reliability and responsiveness in 30% and 0% respectively. Notably, 85% of studies focused exclusively on individuals with spastic CP, only 28% addressed individuals with CP classified in GMFCS levels IV or V.

This review highlights critical gaps in research on trunk control assessment in CP, particularly for patients with severe disabilities, tool responsiveness, and coverage of key facets of trunk control. Future research should prioritize thorough psychometric evaluation of tools, across facets, accounting for the diverse applications and heterogenous clinical presentations in CP.