The term of "core stability" explains the capacity to control the position and movement of the central portion of the body. Core stability training targets the muscles deep within the abdomen that attach to the spine, pelvis and shoulders, that help in the preservation of proper posture and provide the basis for movements of extremities in a coordinated manner. The aim of core stability training is to achieve the optimal physical ability tom the normal state of the spine in daily activities, in addition to developing the endurance and coordination of these core stability muscles.The Core stability may help to improve dynamic balance and muscle coordination between lower and upper extremities, as well as reducing injury risk and muscle imbalances . Core stability exercises have a positive effect on reducing pain, activating deep abdominal muscles, elevating the stability of lumbar spine and improving physical function in patients . The stability of the lumbo-pelvic region is crucial to provide a foundation for movement of the upper and lower extremities, to support loads, and to protect the spinal cord and nerve roots . The core muscles stabilize the spine and trunk during movements such as jumping, running, and throwing .
A clinical diagnosis of diplegic CP made by paediatricians or pediatric neurologists
children spasticity grades must range from 1 to 1+ according to MAS
age must range from 4 to 10 years
They Must be in level I or II on the Gross Motor Function Classifcation System (GMFCS)
A permanent deformity (bony or soft tissue contractures)
visual or auditory defects
Botox application to the lower extremity in the past 6 months or undergone a previous surgical intervention to ankle and knee
history of epileptic seizure and any diagnosed cardiac or orthopaedic disability
Sequential
Core stability exercises
Other interventionExercises applied to trunk , pelvis and abdomen to improve ability to stand , walk and balance.
Pediatric balance scale
To assess the static balance Pediatric Balance Scale scores are divided into 14 items, scored between 0 to 4. What counts as 0 and 4 will vary from exercise to exercise, but 0 is considered the worst performance, and 4 is the best. Retrials are unnecessary if they score a 4 on the first trial. Since each exercise has three trials, the score rating you must tick for each item should be the best of the three trials. Some exercises have time and distance requirements. Points will be deducted if they cannot complete the time and distance requirements and require external support or assistance from another person. After all the exercises have been performed, you simply need to add up all the score ratings per item to calculate the total test score. The maximum score is 56.
Gross motor function classification system
To assess the gross motor function and standing The GMFM is a standardized observational instrument designed and validated to measure change in gross motor function over time in children with cerebral palsy. The scoring key is meant to be a general guideline. However, most of the items have specific descriptors for each score. It is imperative that the guidelines contained in the manual be used for scoring each item. SCORING KEY 0 = does not initiate 1. = initiates 2. = partially completes 3. = completes
Modified Ashworth scale
To measure the degree of spasticity to enroll children in the study scoring 0 No increase in tone 1 slight increase in tone giving a catch when slight increase in muscle tone, manifested by the limb was moved in flexion or extension. 1+ slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout (ROM ) 2 more marked increase in tone but more marked increased in muscle tone through most limb easily flexed 3 considerable increase in tone, passive movement difficult 4 limb rigid in flexion or extension
Weight-Height scale
To measure weight and height to calculate BMI for each patient . The child was wearing a thin layer of clothes to calculate BMI according to the following equation: BMI (Kg/m²)= weight(kg) ÷ height²(m2)
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