posted on 2020-12-04, 10:30authored byClodagh Coman
Children with Cerebral Palsy (CP) demonstrate dysfunctional core muscle
activation contributing to problems with postural control for functional activities
and walking. Pilates-based core exercises aim to improve postural control by
encouraging coordinated activation of deep core stabilising muscles during
functional movements.
This thesis will present the findings of a blinded assessor, parallel, randomised
controlled trial (RCT), with 46 participants, on the effect of Pilates-based core
exercises on balance and gait in ambulant children with spastic CP, ages seven
to 17 years.
The primary objectives were to:
A) measure spatio-temporal and trunk/pelvis kinematic changes in the
performance of a series of gait-related anticipatory and reactive balance tasks
using three dimensional (3D) motion analysis, in children who participated in a
four-week core exercise group (intervention group), compared to children who
continued their usual care (control group). No relevant significant betweengroup
differences were found in gait parameters, measuring at the body
structure and function level of the International Classification of Functioning
Disability and Health (ICF).
and B) to compare changes in balance and functional walking assessments
measuring at the activity level of the ICF; Berg Balance Scale (BBS), Functional
Walking Test (FWT), and Timed Single Leg Stance (TSLS). There was a
significant difference in favour of the intervention group at follow-up; mean
group difference of -1.40,(95%CI: -2.22 to -0.58) on BBS and -1.38,(95%CI:
-2.18 to -0.58) on FWT.
The secondary objective was to analyse the acceptability of the intervention
(core exercise group classes and HEP). Core exercises are a safe, acceptable
and enjoyable intervention for children with CP, as measured by responses
from the subjective participant feedback questionnaire and lack of adverse
events recorded; but relatively low attendance of the core exercise classes and
poor HEP adherence, highlight some difficulties with the intervention as a
whole.
History
First Supervisor
Dr Ailish Malone
Second Supervisor
Dr Dara Meldrum
Comments
A thesis submitted for the degree of Master of Science from the Royal College of Surgeons in Ireland 2019.
Published Citation
Coman C. The effect of a Pilates-based core exercise group on balance and gait in ambulant children with Cerebral Palsy: A Randomised Control Trial [MSc Thesis] Dublin: Royal College of Surgeons in Ireland; 2019