The functional effect of segmental trunk and head control training in moderate-to-severe cerebral palsy: A randomized controlled trial

ABSTRACT

Purpose: To determine whether segmental training is more effective in improving gross motor function in children and young people with moderate-to-severe cerebral palsy than conventional physiotherapy. Methods: Twenty-eight participants were randomized to a segmental training or control group. Outcomes were Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), Segmental Assessment of Trunk Control (SATCo), and postural sway at baseline, at primary endpoint (6 months), and at follow-up (12 months). Results: There were no significant differences in either GMFM, PEDI, or SATCo scores at primary endpoint or follow-up. There were significant reductions in anterior–posterior head angular sway and trunk sway in the segmental training group at primary endpoint but not at follow-up. Conclusion: Segmental training was not superior to usual care in improving GMFM. Improvements in head and trunk sway were greater in the segmental training group at primary endpoint but not at follow-up.

KEYWORDs:

• Cerebral palsy
• motor skills
• postural balance
• physical therapy modalities

Acknowledgments

The authors express their gratitude and thanks to the children and families who participated in the study. Special thanks also go to Dr. Penny Butler and Richard Major for extensive assistance in helping the study group understand, plan and implement targeted training, pediatric physical therapists Lone Nielsen, Tina Winther Jørgensen and Christina Frank Harnfeldt who administered the GMFM assessments and Helle Rasmussen who scored them. Special thanks also to physical therapists Sarah Bew and PT assistant Lynne Ford for scoring the SATCo tests and to The Movement Foundation/The Movement Centre for loaning the equipment for the study and to R82 A/S for help in transporting them.

Funding

This trial was supported financially by grants from The Association of Danish Physiotherapist’s Foundation for Research, Education and Development of Clinical Practice, Fund for Physiotherapy in Private Practice and the Britta Holles Fund. The financial supporters of this study had no involvement in the study design, data collection, data analysis, manuscript preparation and/or publication decisions.

Declaration of interest

The authors have no conflicts of interests to report. The authors alone are responsible for the content and writing of this paper.