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Investigation of Trunk Control and Balance in Adolescents with Hemiplegic Cerebral Palsy

Yıl 2025, Cilt: 12 Sayı: 1, 189 - 201, 30.04.2025

Sultan Seren Ay , Yıldız Erdoganolu , Sinem Asena Sel

Öz

Objectives: In this study, the aim was to compare trunk control and balance in adolescents with hemiplegic cerebral palsy (CP) to their typically developing peers.
Materials and Methods: Thirty-eight participants were included in this study. Nineteen of these children were Level I and II mildly affected children with CP between the ages of 10 and 18 according to the Gross Motor Function Classification system (mean age 13.262.94 years), while the other nineteen were typically developing adolescents between the ages of 10 and 18 (mean age 13.572.85 years). After sociodemographic information of adolescents was obtained, trunk control assessment was done with the Trunk Control Measurement Scale (TCMS) and balance assessment was made with the Pediatric Balance Scale (PBS).
Results: According to the results of the study, there was a significant difference in trunk control (95% CI (50.65 – 54.65), p=0.001) and balance (95% CI (53.21 – 54.99), p=0.001) between adolescents with hemiplegic CP and their typically developing peers.
Conclusion: This study demonstrates that adolescents with mild hemiplegic CP exhibit weaker trunk control and balance compared to their typically developing peers. Even though the level of impairment in adolescents with CP is mild, adding exercises to rehabilitation programs aimed at improving trunk control and balance may contribute to motor development. We believe that this study should be repeated with a larger sample size.

Anahtar Kelimeler

cerebral palsy postural control balance

Kaynakça

  • Akbas, A. N., & Gunel, M. K. (2019). Effects of trunk training on trunk, upper and lower limb motor functions in children with spastic cerebral palsy: a stratified randomized controlled trial. Konuralp Medical Journal, 11(2), 253-259. https://doi.org/10.18521/ktd.453532
  • Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., ... & Damiano, D. (2005). Proposed definition and classification of cerebral palsy, April 2005. Developmental medicine and child neurology, 47(8), 571-576. https://doi.org/10.1017/S001216220500112X
  • Bingöl, H., & Demirtaş Karaoba, D. (2024). A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components. Perceptual and Motor Skills, 00315125241254130 https://doi.org/10.1177/00315125241254130
  • Bingöl, H., & Demirtaş Karaoba, D. (2024). Diplejik Serebral Palsi’li Çocuklarda Katılım Kısıtlılıkları, Gövde Dengesi, Dinamik Denge ve Çevresel Faktörlerin Yapısal Eşitlik Modellemesi. Hacettepe University Faculty of Health Sciences Journal, 11(2), 601-614. https://doi.org/10.21020/husbfd.1397362
  • Brundavanam, I., Gadde, L., Balne, N., & Purohit, A. (2015). Effect of dynamic sitting balance on upper extremity motor skills in children having spastic diplegia: A correlational study. Indian Journal of Cerebral Palsy, 1(2). 10.4103/2395-4264.173429
  • Donker, S. F., Ledebt, A., Roerdink, M., Savelsbergh, G. J., & Beek, P. J. (2008). Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children. Experimental brain research, 184, 363-370. 10.1007/s00221-007-1105-y
  • El, Ö., Baydar, M., Berk, H., Peker, Ö., Koşay, C., & Demiral, Y. (2012). Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disability and rehabilitation, 34(12), 1030-1033. https://doi.org/10.3109/09638288.2011.632466
  • Erden, A., Acar Arslan, E., Dündar, B., Topbaş, M., & Cavlak, U. (2021). Reliability and validity of Turkish version of pediatric balance scale. Acta Neurologica Belgica, 121(3), 669-675. 10.1007/s13760-020-01302-9
  • Franjoine, M. R., Gunther, J. S., & Taylor, M. J. (2003). Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatric physical therapy, 15(2), 114-128. 10.1097/01.PEP.0000068117.48023.18
  • Heyrman, L., Desloovere, K., Molenaers, G., Verheyden, G., Klingels, K., Monbaliu, E., & Feys, H. (2013). Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Research in developmental disabilities, 34(1), 327-334. https://doi.org/10.1016/j.ridd.2012.08.015
  • Heyrman, L., Feys, H., Molenaers, G., Jaspers, E., Monari, D., Nieuwenhuys, A., & Desloovere, K. (2014). Altered trunk movements during gait in children with spastic diplegia: compensatory or underlying trunk control deficit?. Research in developmental disabilities, 35(9), 2044-2052. https://doi.org/10.1016/j.ridd.2014.04.031
  • Heyrman, L., Molenaers, G., Desloovere, K., Verheyden, G., De Cat, J., Monbaliu, E., & Feys, H. (2011). A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale. Research in developmental disabilities, 32(6), 2624-2635. https://doi.org/10.1016/j.ridd.2011.06.012
  • Kembhavi, G., Darrah, J., Magill-Evans, J., & Loomis, J. (2002). Using the berg balance scale to distinguish balance abilities in children with cerebral palsy. Pediatric physical therapy, 14(2), 92-99. 10.1097/00001577-200214020-00005
  • Kim, D. H., An, D. H., & Yoo, W. G. (2018). Changes in trunk sway and impairment during sitting and standing in children with cerebral palsy. Technology and Health Care, 26(5), 761-768. Doi: 10.3233/THC-181301
  • Ko, M. S., Sim, Y. J., Kim, D. H., & Jeon, H. S. (2016). Effects of three weeks of whole-body vibration training on joint-position sense, balance, and gait in children with cerebral palsy: a randomized controlled study. Physiotherapy Canada, 68(2), 99-105. https://doi.org/10.3138/ptc.2014-77
  • Liao, H. F., & Hwang, A. W. (2003). Relations of balance function and gross motor ability for children with cerebral palsy. Perceptual and motor skills, 96(3), 1173-1184. https://doi.org/10.2466/pms.2003.96.3c.117
  • Malone, A., Kiernan, D., French, H., Saunders, V., & O'Brien, T. (2016). Obstacle crossing during gait in children with cerebral palsy: cross-sectional study with kinematic analysis of dynamic balance and trunk control. Physical therapy, 96(8), 1208-1215. https://doi.org/10.2522/ptj.20150360
  • Ozal, C., Ari, G., & Gunel, M. K. (2019). Inter–intra observer reliability and validity of the Turkish version of Trunk Control Measurement Scale in children with cerebral palsy. Acta Orthopaedica et Traumatologica Turcica, 53(5), 381-384. https://doi.org/10.1016/j.aott.2019.04.013
  • Özal, C., & Günel, M. K. (2014). Spastik serebral palsili çocuklarda gövde kontrolü ile fonksiyonel mobilite ve denge arasındaki ilişkinin incelenmesi. Journal of Exercise Therapy and Rehabilitation, 1(1), 1-8.
  • Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 50(10), 744-750. https://doi.org/10.1111/j.1469-8749.2008.03089.x
  • Panibatla, S., Kumar, V., & Narayan, A. (2017). Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. Journal of clinical and diagnostic research: JCDR, 11(9), YC05. 10.7860/JCDR/2017/28388.10649
  • Sæther, R., Helbostad, J. L., Adde, L., Brændvik, S., Lydersen, S., & Vik, T. (2015). The relationship between trunk control in sitting and during gait in children and adolescents with cerebral palsy. Developmental Medicine & Child Neurology, 57(4), 344-350. https://doi.org/10.1111/dmcn.12628
  • Smorenburg, A. R., Ledebt, A., Deconinck, F. J., & Savelsbergh, G. J. (2011). Visual feedback of the non-moving limb improves active joint-position sense of the impaired limb in Spastic Hemiparetic Cerebral Palsy. Research in developmental disabilities, 32(3), 1107-1116. https://doi.org/10.1016/j.ridd.2011.01.016
  • Şimşek, A., Yıldız, R., & Elbasan, B. (2017). Hemiplejik ve diplejik serebral palsili çocuklarda gövde kontrolü ile denge arasindaki ilişkinin incelenmesi. Fizyoterapi Rehabilitasyon, 28(2), 68-72. https://doi.org/10.21653/tfrd.336349
  • Tarfa, H. B., Hassan, A. B., Badaru, U. M., & Abdullahi, A. (2021). Predictors of gross motor function and activities of daily living in children with cerebral palsy. International Journal of Rehabilitation Research, 44(4), 330-335. Doi: 10.1097/MRR.0000000000000497
  • Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.
  • Yam, W. K. L., & Leung, M. S. M. (2006). Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy. Journal of child neurology, 21(12), 1031-1035. https://doi.org/10.1177/7010.2006.00222
  • Yildiz, A., Yildiz, R., & Elbasan, B. (2018). Trunk control in children with cerebral palsy and its association with upper extremity functions. Journal of Developmental and Physical Disabilities, 30, 669-676. 10.1007/s10882-018-9611-3

Hemiplejik Serebral Palsili Adölesanlarda Gövde Kontrolü ve Dengenin İncelenmesi

Yıl 2025, Cilt: 12 Sayı: 1, 189 - 201, 30.04.2025

Sultan Seren Ay , Yıldız Erdoganolu , Sinem Asena Sel

Öz

Amaç: Bu çalışmada, hemiplejik serebral palsili adölesanlarda gövde kontrolü ve dengenin tipik gelişim gösteren yaşıtları ile karşılaştırılması amaçlandı.
Gereç ve Yöntem: Çalışmaya 38 çocuk dahil edildi. Bu çocukların 19’u Kaba Motor Fonksiyon Sınıflandırma sistemine göre Seviye I ve II hafif etkilenimli 10-18 yaş arası SP’li çocuk iken (ortalama yaş 13,262,94 yıl), diğer 19’u ise tipik gelişim gösteren 10-18 yaş arası 19 adölesandan (ortalama yaş 13,572,85 yıl) oluşmaktaydı. Çocukların sosyodemografik bilgileri alındıktan sonra “Gövde Kontrol Ölçüm Skalası” (GKÖS) ile gövde kontrolü, Pediatrik Denge Skalası (PBS) ile denge değerlendirmesi yapıldı.
Bulgular: Çalışmanın sonucuna göre hemiplejik SP’li adölesanlar ile tipik gelişim gösteren yaşıtları arasında gövde kontrolü (%95 CI (50,65 – 54,65), p=0,001) ve denge (%95 CI (53,21 – 54,99), p=0,001) açısından anlamlı fark bulundu.
Sonuç: Bu çalışma, hafif etkilenimli SP’li adölesanların tipik gelişim gösteren yaşıtlarına kıyasla gövde kontrolü ve dengenin daha zayıf olduğunu göstermektedir. SP'li adölesanlarda etkilenim düzeyi hafif olsa da rehabilitasyon programlarına gövde kontrolünü ve dengeyi geliştirecek egzersizlerin eklenmesinin motor gelişime katkı sağlayabileceğini ve bu çalışmanın daha geniş bir örneklemle tekrarlanması gerektiğini düşünmekteyiz.

Anahtar Kelimeler

serebral palsi postüral kontrol denge

Kaynakça

  • Akbas, A. N., & Gunel, M. K. (2019). Effects of trunk training on trunk, upper and lower limb motor functions in children with spastic cerebral palsy: a stratified randomized controlled trial. Konuralp Medical Journal, 11(2), 253-259. https://doi.org/10.18521/ktd.453532
  • Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., ... & Damiano, D. (2005). Proposed definition and classification of cerebral palsy, April 2005. Developmental medicine and child neurology, 47(8), 571-576. https://doi.org/10.1017/S001216220500112X
  • Bingöl, H., & Demirtaş Karaoba, D. (2024). A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components. Perceptual and Motor Skills, 00315125241254130 https://doi.org/10.1177/00315125241254130
  • Bingöl, H., & Demirtaş Karaoba, D. (2024). Diplejik Serebral Palsi’li Çocuklarda Katılım Kısıtlılıkları, Gövde Dengesi, Dinamik Denge ve Çevresel Faktörlerin Yapısal Eşitlik Modellemesi. Hacettepe University Faculty of Health Sciences Journal, 11(2), 601-614. https://doi.org/10.21020/husbfd.1397362
  • Brundavanam, I., Gadde, L., Balne, N., & Purohit, A. (2015). Effect of dynamic sitting balance on upper extremity motor skills in children having spastic diplegia: A correlational study. Indian Journal of Cerebral Palsy, 1(2). 10.4103/2395-4264.173429
  • Donker, S. F., Ledebt, A., Roerdink, M., Savelsbergh, G. J., & Beek, P. J. (2008). Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children. Experimental brain research, 184, 363-370. 10.1007/s00221-007-1105-y
  • El, Ö., Baydar, M., Berk, H., Peker, Ö., Koşay, C., & Demiral, Y. (2012). Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disability and rehabilitation, 34(12), 1030-1033. https://doi.org/10.3109/09638288.2011.632466
  • Erden, A., Acar Arslan, E., Dündar, B., Topbaş, M., & Cavlak, U. (2021). Reliability and validity of Turkish version of pediatric balance scale. Acta Neurologica Belgica, 121(3), 669-675. 10.1007/s13760-020-01302-9
  • Franjoine, M. R., Gunther, J. S., & Taylor, M. J. (2003). Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatric physical therapy, 15(2), 114-128. 10.1097/01.PEP.0000068117.48023.18
  • Heyrman, L., Desloovere, K., Molenaers, G., Verheyden, G., Klingels, K., Monbaliu, E., & Feys, H. (2013). Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Research in developmental disabilities, 34(1), 327-334. https://doi.org/10.1016/j.ridd.2012.08.015
  • Heyrman, L., Feys, H., Molenaers, G., Jaspers, E., Monari, D., Nieuwenhuys, A., & Desloovere, K. (2014). Altered trunk movements during gait in children with spastic diplegia: compensatory or underlying trunk control deficit?. Research in developmental disabilities, 35(9), 2044-2052. https://doi.org/10.1016/j.ridd.2014.04.031
  • Heyrman, L., Molenaers, G., Desloovere, K., Verheyden, G., De Cat, J., Monbaliu, E., & Feys, H. (2011). A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale. Research in developmental disabilities, 32(6), 2624-2635. https://doi.org/10.1016/j.ridd.2011.06.012
  • Kembhavi, G., Darrah, J., Magill-Evans, J., & Loomis, J. (2002). Using the berg balance scale to distinguish balance abilities in children with cerebral palsy. Pediatric physical therapy, 14(2), 92-99. 10.1097/00001577-200214020-00005
  • Kim, D. H., An, D. H., & Yoo, W. G. (2018). Changes in trunk sway and impairment during sitting and standing in children with cerebral palsy. Technology and Health Care, 26(5), 761-768. Doi: 10.3233/THC-181301
  • Ko, M. S., Sim, Y. J., Kim, D. H., & Jeon, H. S. (2016). Effects of three weeks of whole-body vibration training on joint-position sense, balance, and gait in children with cerebral palsy: a randomized controlled study. Physiotherapy Canada, 68(2), 99-105. https://doi.org/10.3138/ptc.2014-77
  • Liao, H. F., & Hwang, A. W. (2003). Relations of balance function and gross motor ability for children with cerebral palsy. Perceptual and motor skills, 96(3), 1173-1184. https://doi.org/10.2466/pms.2003.96.3c.117
  • Malone, A., Kiernan, D., French, H., Saunders, V., & O'Brien, T. (2016). Obstacle crossing during gait in children with cerebral palsy: cross-sectional study with kinematic analysis of dynamic balance and trunk control. Physical therapy, 96(8), 1208-1215. https://doi.org/10.2522/ptj.20150360
  • Ozal, C., Ari, G., & Gunel, M. K. (2019). Inter–intra observer reliability and validity of the Turkish version of Trunk Control Measurement Scale in children with cerebral palsy. Acta Orthopaedica et Traumatologica Turcica, 53(5), 381-384. https://doi.org/10.1016/j.aott.2019.04.013
  • Özal, C., & Günel, M. K. (2014). Spastik serebral palsili çocuklarda gövde kontrolü ile fonksiyonel mobilite ve denge arasındaki ilişkinin incelenmesi. Journal of Exercise Therapy and Rehabilitation, 1(1), 1-8.
  • Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 50(10), 744-750. https://doi.org/10.1111/j.1469-8749.2008.03089.x
  • Panibatla, S., Kumar, V., & Narayan, A. (2017). Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. Journal of clinical and diagnostic research: JCDR, 11(9), YC05. 10.7860/JCDR/2017/28388.10649
  • Sæther, R., Helbostad, J. L., Adde, L., Brændvik, S., Lydersen, S., & Vik, T. (2015). The relationship between trunk control in sitting and during gait in children and adolescents with cerebral palsy. Developmental Medicine & Child Neurology, 57(4), 344-350. https://doi.org/10.1111/dmcn.12628
  • Smorenburg, A. R., Ledebt, A., Deconinck, F. J., & Savelsbergh, G. J. (2011). Visual feedback of the non-moving limb improves active joint-position sense of the impaired limb in Spastic Hemiparetic Cerebral Palsy. Research in developmental disabilities, 32(3), 1107-1116. https://doi.org/10.1016/j.ridd.2011.01.016
  • Şimşek, A., Yıldız, R., & Elbasan, B. (2017). Hemiplejik ve diplejik serebral palsili çocuklarda gövde kontrolü ile denge arasindaki ilişkinin incelenmesi. Fizyoterapi Rehabilitasyon, 28(2), 68-72. https://doi.org/10.21653/tfrd.336349
  • Tarfa, H. B., Hassan, A. B., Badaru, U. M., & Abdullahi, A. (2021). Predictors of gross motor function and activities of daily living in children with cerebral palsy. International Journal of Rehabilitation Research, 44(4), 330-335. Doi: 10.1097/MRR.0000000000000497
  • Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.
  • Yam, W. K. L., & Leung, M. S. M. (2006). Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy. Journal of child neurology, 21(12), 1031-1035. https://doi.org/10.1177/7010.2006.00222
  • Yildiz, A., Yildiz, R., & Elbasan, B. (2018). Trunk control in children with cerebral palsy and its association with upper extremity functions. Journal of Developmental and Physical Disabilities, 30, 669-676. 10.1007/s10882-018-9611-3
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fizyoterapi
Bölüm Makaleler
Yazarlar

Sultan Seren Ay 0000-0003-4362-4983

Yıldız Erdoganolu 0000-0002-9909-6561

Sinem Asena Sel 0000-0001-6409-5414

Erken Görünüm Tarihi 30 Nisan 2025
Yayımlanma Tarihi 30 Nisan 2025
Gönderilme Tarihi 1 Temmuz 2024
Kabul Tarihi 18 Kasım 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 12 Sayı: 1

Kaynak Göster

APA Ay, S. S., Erdoganolu, Y., & Sel, S. A. (2025). Investigation of Trunk Control and Balance in Adolescents with Hemiplegic Cerebral Palsy. Hacettepe University Faculty of Health Sciences Journal, 12(1), 189-201. https://doi.org/10.21020/husbfd.1507491
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