The Relationship Between Selective Motor Control and Trunk Control in Children With Spastic Cerebral Palsy

Abstract

Aim: Cerebral palsy (CP) can cause a variety of musculoskeletal issues that impact everyday functioning and activities, including reduced muscle tone and selective motor control. Appropriate evaluation of these problems and determination of their interrelationships are important in treatment planning. The aim of this study was to investigate the correlation between control of the trunk and selectivity of the lower limbs in children with CP. Material and Method: Sixty-eight children and adolescents with spastic CP, categorized as GMFCS levels I to III and aged between five and seventeen years, were enrolled in the present study. The Trunk Control Measurement Scale (TCMS) was utilized to evaluate the trunk control. The Selective Control Assessment of the Lower Extremity (SCALE) was performed to measure the selectivity of the lower extremity. Groups with varying GMFCS levels were analyzed using the Kruskal-Wallis test. For the relationship analysis, the Spearman rank correlation test was employed. Results: Significant differences in total SCALE scores between levels of the GMFCS were found in the group comparisons (Kruskal- Wallis H test: 44.145, p<0.001). SCALE scores and TCMS scores showed a substantial high association for dynamic sitting balance (rho:0.743, p<0.001), selective movement control (rho: 0.739, p<0.001), and overall TCMS scores (rho: 0.767, p<0.001). TCMS dynamic reaching (rho: 0.676) and static sitting balance (rho: 0.690) had a moderate positive correlation with SCALE score (p<0.001). Conclusion: The SCALE test, which is simple to administer in a clinical setting, may provide insight into the level of trunk control. To improve selectivity of the lower limbs, physiotherapy programs may include interventions related to trunk control.