TRUNK CONTROL BALANCE AND UPPER EXTREMITY FUNCTION IN AMBULATORY CHILDREN WITH DIPLEGIC CEREBRAL PALSY: A COMPARATIVE STUDY.

Introduction: This study aimed to investigate trunk control, balance, and upper extremity skills quality in ambulatory children with diplegic cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS)-I and -II, as well as to compare the GMFCS groups among themselves and with healthy children.

Methods: Twenty-five children with spastic diplegic CP (11.80 ± 2.66 years) and 30 healthy children (13.57 ± 3.48 years) were included. Functional levels were classified with the GMFCS, with 13 children classified as GMFCS-I and 12 as GMFCS-II, while trunk control was assessed with the Trunk Control Measurement Scale (TCMS), balance with the Single-Leg Stance and Four Square Step Tests, and upper extremity functionality with the Quality of Upper Extremity Skills Test (QUEST).

Results: There was no significant difference in age, body mass index, or gender distribution between the CP and control groups (p > 0.05). The healthy group outperformed both CP groups in all clinical evaluations. No significant differences were found between GMFCS-I and GMFCS-II groups in the Single-Leg Stance Test, Four Square Step Test, and QUEST parameters (p > 0.05). However, TCMS subdomains-static sitting (p = 0.009), dynamic reaching (p = 0.018), selective movement control (p = 0.012), and total scores (p = 0.006) were significantly higher in the GMFCS-I group. A moderate positive correlation and a 54% regression rate were observed between the QUEST and TCMS scores.

Conclusion: Trunk control is a key determinant of upper extremity skill quality in children with CP. Core stabilization should be prioritized to improve upper extremity functionality and manage disability levels effectively.