The Problem Solving Strategy of Poor Core Stability in Children with Cerebral Palsy: A Clinical Trial

Sitting is the earliest upright posture that is achieved during the normal development. The capacity to maintain balance in sitting is a pre-requisite to the activities of daily living. Core stability is the ability to control position and movement of central portion of the body. Children with cerebral palsy have poor central control which affects sitting balance. Although core stability is important for sitting balance, there are scarce studies that demonstrate core stability training in cerebral palsy. Purpose: to study the effect of core stability training program on sitting control in children with cerebral palsy and to design a problem solving strategy for poor core stability based on Neuro-Developmental Therapy (NDT). Subjects: 26 spastic diplegic children were divided into two groups; the group A; 12 children with a mean age (2.45±0.86) and group B; 14 children with a mean age (2.57±0.97). Group A received selected physical therapy program while Group B received an especially designed physical therapy program for core stability based on the NDT. Both groups received therapy for one hour, three times weekly for successive two months. Methods: the functional motor skills were evaluated using the Gross Motor Function Measure (GMFM) scale before and after the treatment. Results: The paired t-test revealed that the gross motor function of children from both groups improved significantly after two months of treatment in both lying and sitting domains (P=0.04 for lying and P=0.001 for sitting domain in group A while group B P= 0.0001 in lying and sitting domains). The unpaired t-test revealed that the children in group B performed better and showed significantly greater improvement than those in group A (P=0.004 in lying and 0.02 in sitting domain). Conclusion: The core stability is essential for postural sitting control. Neurodevelopmental therapy is a valuable approach for improving functional sitting outcomes.