Core Training May Improve Posture, Walking Ability in Kids with Cerebral Palsy, Study Finds

Adding core stability exercises to physical therapy improves trunk endurance — the ability to withstand fatigue — and walking ability in children with hemiplegic cerebral palsy, according to researchers.

Their small study, “Trunk endurance and gait changes after core stability training in children with hemiplegic cerebral palsy: A randomized controlled trial,” was published in the Journal of Back and Musculoskeletal Rehabilitation.

Hemiplegic cerebral palsy, which affects movement on only one side of the body, is the most common form of cerebral palsy. It frequently affects the ability of children to keep an upright position, maintain standing balance, coordinate movement, and be able to walk.

Core muscles — those around the trunk and pelvis — are the base of support for the body. They keep it balanced and stable, and connect the upper and lower body. Core muscles are essential for movement, such as walking.

Lower core strength, endurance, and stability may be responsible for reduced functional capacity and impaired motor skills in children with cerebral palsy.

The study, from Cairo University in Egypt, evaluated the beneficial effects of adding core stability training to physical therapy on trunk endurance and walking ability in 30 children with hemiplegic cerebral palsy.

The 17 boys and 13 girls ages 10 to 12 were randomly assigned to either a predefined physical therapy program with additional core stability training, or to physical therapy alone, three times a week for eight weeks.

Endurance time of trunk muscles was measured with four tests where the child was asked to hold specific positions that mainly required the trunk muscles for as long as possible. Walking ability parameters, such as step length, walking speed, and time of support on the affected side, were assessed using the Biodex Gait Trainer 2TM.

All tests were performed at the beginning of the study and after eight weeks of physical therapy.

Both groups showed improvement in trunk endurance and walking ability, but children who had the additional core training showed significantly greater improvement.

Also, the endurance time of the lateral trunk muscles was significantly improved only in children who had the core stability training, suggesting that predefined physical therapy does not work those muscles to a great extent.

These findings suggest that “a stable and strong core may contribute to more efficient use of the lower limbs which could enhance the [patients’] walking ability and velocity,” researchers wrote.

Larger studies with longer training times are necessary to confirm these results, and “future studies investigating the effect of core stability exercises within the context of occupational therapy for children with [cerebral palsy] may be useful to direct the clinical practice.”