Effect of task-oriented training on postural control in children with spastic diplegic cerebral palsy: a randomized controlled trial
Article Sidebar
Main Article Content
Abstract
Cerebral palsy is a leading cause of childhood-onset motor disability. Impaired postural control in children with cerebral palsy limits daily participation and increases lifelong reliant on caregivers. Therefore, interventions should prioritize improving postural control in these groups. This study aimed to compare the effect of task-oriented training (TOT) and conventional physiotherapy (CPT) on postural control in children with spastic diplegic cerebral palsy. A single-blinded randomized controlled trial study was conducted with 28 participants aged 3-15 years, randomly allocated into the TOT group and the CPT group. Both groups practiced for 60 minutes sessions, 3 times per week, for 6 weeks. Postural control was assessed using Pediatric Balance Scale at baseline, after 4th week, and 6th week of treatment. Data were analyzed using Friedman test for within-group comparisons across time points, while the Wilcoxson Signed-Rank test and the Mann-Whitney U test were used for within- and between- groups comparisons at each assessment period. Statistical significance was set at p-value < 0.05. Both groups showed significant improvement after 6 weeks of treatment; however, the TOT group demonstrated greater improvements (mean differences value of 6.85 points) compared to the CPT group (mean differences value of 4.36 points). These findings indicate that TOT significantly improves postural control in children with spastic diplegic cerebral palsy, yielding better outcomes than CPT.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, et al. Global prevalence of cerebral palsy: A systematic analysis. Dev Med Child Neurol 2022; 64(12): 1494–1506. https://doi.org/10.1111/ dmcn.15346.
Burgess A, Sakzewski L, Sakzewski L, Whittingham K, Wotherspoon J, Chatfield MD, et al. Development of social functioning in children with cerebral palsy: A longitudinal study. Dev Med Child Neurol 2023; 65(5): 674–82.
Berker N, Yalcin S. The Help Guide to Cerebral Palsy. 2nd Edition. Merrill Corporation: Washinton; 2010: pp 12–104.
Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: A modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther 2003; 15(2): 114–28.
Chen CL, Shen IH, Chen CY, Wuc CY, Liu WY, Chung CY. Validity, responsiveness, minimal detectable change, and minimal clinically important change of pediatric balance scale in children with cerebral palsy. Res Dev Disabil 2013; 34(3): 916–22.
Towns M, Lindsay S, Arbour-Nicitopoulos K, Mansfield A, Wright FV. Balance confidence and physical activity participation of independently ambulatory youth with cerebral palsy: An exploration of youths’ and parents’ perspectives. Disabil Rehabil 2020; doi: 10.1080/09638288.2020.1830191.
Ismail A, Sk Abd Razak R, Suddin LS, Mahmud A, Kamaralzaman S, Yusri G. The economic burden and determinant factors of parents/ caregivers of children with cerebral palsy in Malaysia: A mixed methods study. Int J Environ Res Public Health 2022; 19: 475.
de Araújoa PA, Starling JMP, Oliveirac VC, Gontijoa APB, Mancini MC. Combining balance-training interventions with other active interventions may enhance effects on postural control in children and adolescents with cerebral palsy: A systematic review and meta-analysis. Braz J Physl Ther 2019; 24(4): 295-305.
Dewar R, Love S, Johnston LM. Exercise interventions improve postural control in children with cerebral palsy: A systematic review. Dev Med Child Neurol 2014; 57: 504–20.
Choi Y, Jung H. A Commentary on task-oriented interventions in the functional mobility and postural control of children with cerebral palsy. Int J Neurorehabilitation 2018; 5(2): 314.
Jackman M, Lannin N, Galea C, Sakzewski L, Miller L, Novak I. What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review. Aust Occup Ther J. 2020; 67:269– 80. doi: 10.1111/1440-1630.12666.
Rossi F, Gianola S, Corvetti L. Regulation of intrinsic neuronal properties for axon growth and regeneration. Prog Neurobiol 2007; 81: 1–28.
Karnadipa T, Xin W, Pickering D, Carrier J. Effectiveness of task-specific training for improving balance performance in children with cerebral palsy (CP): A narrative systematic review. Physiother Q 2024; 32(1): 15–24.
Shaju. Study on efficacy of task-oriented training on mobility and balance among spastic diplegic cerebral palsy children. J Neurol Neurosurg 2016; 1(3): 555562.
Hidecker MJC, Paneth N, Rosenbaum PL, Kent RD, Lillie J, Eulenberg JB, et al. Developing and validating the communication function classification system for individuals with cerebral palsy. Dev Med Child Neurol. 2011; 53(8): 704-710. doi:10.1111/ j.1469-8749. 2011. 03996.x.
Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content Validity of the Expanded and Revised Gross Motor Function Classification System. Dev. Med. Child Neurol. 2008; 50: 744-750. doi:10.1111/j.1469-8749. 2008. 03089.x.
Kim JH, Choi YE. The effect of task-oriented training on mobility function, postural stability in children with cerebral palsy. J Korean Soc Phys Med 2017; 12(3): 79–84.
Madhumathi K, Selvam PS, Megala K. Efficacy of task-oriented training on balance and gross motor function in spastic diplegic cerebral palsy children. Paripex - Indian J Res 2020; 9(4). doi: 10.36106/paripex.
Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of functional balance assessment in children with cerebral palsy. Neurorehabil Neural Repair 2008; 22(6): 745–53.
Erden A, Arslan EA, Dündar B, Topbaş M, Cavlak U. Reliability and validity of Turkish version of pediatric balance scale. Acta Neurol Belg 2020; doi: 10.1007/s13760-020-01302-9.
Franjoine MR, Darr N, Young B, McCoy SW and Fiss AL. Examination of the effects of age, sex, and motor ability level on balance capabilities in children with cerebral palsy GMFCS levels I, II, III and typical development using the Pediatric Balance Scale. Dev Neurorehabil 2021; doi: 10.1080/ 17518423.2021.1943033.
Sah AK, Balaji GK, Agrahara S. Effects of task-oriented activities based on neurodevelopmental therapy principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy. J Pediatr Neurosci 2019; 14: 120–6.
Hotari SP. Effect of therapist-delivered task-oriented training on functional mobility and balance in children with cerebral palsy: A systematic review and meta-analysis [Master’s thesis]. Tromsø: UiT The Arctic University of Norway; 2022.
Zai W, Xu N, Wu W, Wang Y, Wang R. Effect of task-oriented training on gross motor function, balance and activities of daily living in children with cerebral palsy: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101: 44.
