Effect of Functional Trunk Training Program on Gait Harmony in Children with Spastic Diplegia: A Randomized Controlled Trial

Abstract

Purpose. To determine the effect of functional trunk training on gait harmony in children with spastic diplegic CP by using the core stability and gait training program through strengthen the core area and the modified walker tool. Design. Single blind randomized controlled trial. Methods. Thirty children with CP spastic diplegia participated in this study with ages between four to seven years. They were randomly and equally divided into two groups (A and B), the control and study group respectively. Group A received selected physical therapy program for two hours aiming to improve functional gait ability while group B received the same as group A for only one hour plus the intervention program. The intervention program which is aiming to improve gait harmony consists of two fundamental parts. Firstly, core training and mobility exercises for half an hour. Secondly, gait training on different surfaces by using Modified walker for half an hour. Treatment was conducted for 3 times per week for a successive 3 months for both groups (control A & study B). Modified Ashworth scale (MAS) was used for sample selection. Gait harmony was measured by golden ratio equations which determine the spatiotemporal data from tracker motion analysis program version 5.0.6. Results. By using descriptive analysis to show mean ± standard deviation (SD) for all comparative variables, non-parametric test (chi square) to express the MAS values pretreatment for selection, paired t-test for measuring the pre and post treatment results within group and independent t-test between both groups (control and study) for measuring the results of Gross Motor Function Measure score (GMFM) for walking domain that showed a significant difference between both groups (A & B) post treatment. Usage of multivariate analysis (MANOVA) multivariate to determine the effect of independent variables (side, time and the intervention in both groups A&B) on the dependent variables equation (a, b, and the difference between both equations). There was a significant difference in the following: the proportion of stance/ swing phase time (equation a), the proportion of gait cycle/ stance phase time (equation b) and the difference between the values of both proportions (equation a and b) between both groups. Conclusion. It can be concluded that functional trunk training program in conjunction with a selected physical therapy program improved the gait harmony significantly in children with spastic diplegic CP. Which is obvious in gait harmony equations.