Effect of Intensive Segmental Trunk Training on Upper Extremity Function and Seated Postural Stability in Children With Spastic Diplegic Cerebral Palsy

NCT07692087 | Completed DMC

• 1 other identifier: UOL/IREB/26/21.1/01/01
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized controlled trial is to evaluate whether intensive segmental trunk training (ISTT) can improve upper extremity function and seated postural stability in children aged 4-12 years with spastic diplegic cerebral palsy and moderate trunk control impairments. The main questions it aims to answer are: Does intensive segmental trunk training lead to greater improvements in seated postural stability compared to standard physical therapy? Does intensive segmental trunk training lead to greater improvements in upper extremity function compared to standard physical therapy? Researchers compared the ISTT group to the control group (standard physical therapy) to see if the targeted trunk training produces significantly better outcomes in trunk control, upper extremity skills, and gross motor function. Participants underwent their assigned training regimen five times per week for eight weeks and complete pre- and post-intervention assessments measuring trunk control (SATCo, TCT), upper extremity function (QUEST, Box and Block Test), and gross motor function (GMFM-88).

Conditions

Diplegic Cerebral Palsy; Cerebral Palsy (CP); Trunk Mobility; Upper Extremity Function; Postural Stability; Diplegic Spastic Cerebral Palsy

Keywords

cerebral palsy; postural stability; trunk control; Upper extremity; seated position; motor skills; spastic diplegic cerebral palsy

Outcome Measures

Primary Outcomes (1)

• Segmental Assessment of Trunk Control (SATCo) - change in seated postural stability

  A reliable and valid measure that assesses segmental trunk control at cervical, thoracic, and lumbar levels in sitting. Scores range from 0 (no trunk control) to 20 (full segmental trunk control), with higher scores indicating better seated postural stability.

  Baseline, immediately post-intervention (Week 8)

Secondary Outcomes (4)

• Quality of Upper Extremity Skills Test (QUEST) - Change in upper extremity function

  Baseline, immediately post-intervention (Week 8)

• Box and Block Test (BBT) - Change in manual dexterity

  Baseline, immediately post-intervention (Week 8)

• Gross Motor Function Measure (GMFM-88) - Change in gross motor function

  Baseline, immediately post-intervention (Week 8)

• Trunk Control Test (TCT) - change in trunk control

  Baseline, immediately post-intervention (Week 8)

Study Arms (2)

Intensive Segmental Trunk Training (ISTT) Group

EXPERIMENTAL

Participants received specialized segmental trunk training targeting the thoracic, lumbar, and pelvic levels, five times per week for eight weeks (40 sessions, 60 minutes each). Exercises progressed from static to dynamic seated balance and included pelvic tilt facilitation, isolated segmental mobilization during weight shifting, trunk rotation with reaching tasks, and perturbation-based reactive balance training using a tilt board.

Other: Intensive Segmental Trunk Training

Control Group (Standard Physical Therapy)

ACTIVE COMPARATOR

Participants received standard physical therapy of equal duration and frequency (five times per week for eight weeks, 60 minutes per session), emphasizing neurodevelopmental treatment (NDT) principles, passive stretching of lower extremity muscles, lower limb strengthening, and gait training.

Other: Standard Physical Therapy

Interventions

Intensive Segmental Trunk Training OTHER

A structured, progressive training program targeting segmental trunk control at the thoracic, lumbar, and pelvic levels. Conducted five times per week for eight weeks (40 sessions, 60 minutes each). Exercises progress from static to dynamic seated balance and include pelvic tilt facilitation, isolated segmental mobilization during weight shifting, trunk rotation with reaching tasks, and perturbation-based reactive balance training using a tilt board. Difficulty is advanced based on individual tolerance and performance.

Intensive Segmental Trunk Training (ISTT) Group

Standard Physical Therapy OTHER

Conventional physical therapy based on neurodevelopmental treatment (NDT) principles, involving passive stretching of lower extremity muscles, lower limb strengthening, and gait training. Delivered at the same frequency and duration as the experimental intervention (five times per week, 60 minutes per session, for eight weeks).

Control Group (Standard Physical Therapy)

Eligibility Criteria

• Age: 4 Years - 12 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Participants included were aged 4-12 years
• Gross Motor Function Classification System (GMFCS) Levels II-IV
• ability to sit independently for at least 10 seconds
• follow simple verbal instructions
• moderate trunk control impairment, defined as a score of ≤ 3 on the Trunk Control Test (TCT) item assessing sitting without arm support
• Children with trunk control scores within a moderate impairment range on the Segmental Assessment of Trunk Control (SATCo).
• Parental consent was obtained prior to participation.

You may not qualify if:

• Children with cognitive impairments severe enough to limit task comprehension
• uncontrolled seizures
• history of surgical interventions or Botulinum toxin injections in the preceding 6 months
• receiving other therapeutic interventions targeting trunk control or upper limb function concurrently were excluded.

Sponsors & Collaborators

• University of Lahore: lead
• University of Lahore Hospital (ULH): collaborator

Study Sites (1)

Pediatric Physical Therapy and Neurorehabilitation Department at the University of Lahore Teaching Hospital

Lahore, Punjab Province, Pakistan

Location

MeSH Terms

Conditions

Cerebral Palsy; Cerebral palsy, spastic, diplegic

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 2, 2026
• First Posted: July 9, 2026
• Study Start: May 24, 2024
• Primary Completion: October 30, 2024
• Study Completion: March 30, 2025
• Last Updated: July 30, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, CSR
• Time Frame: Immediately following publication and with no end date.
• Access Criteria: The datasets generated during and/or analysed during the current study will be available upon request from Dr. Iqra Khan, PT, with email address: iqrakhan485@gmail.com

Locations

PA (1)