Comparative Effects of Perturbation and Trunk Control Training in Children with Cerebral Palsy

Abstract

Background: Cerebral palsy (CP) is a leading cause of physical disability in children, often associated with impaired trunk stability, postural misalignment, and reduced balance, which collectively limit motor function and daily independence. Physiotherapy approaches such as perturbation training and trunk control training have been proposed to address these deficits, but their comparative effectiveness remains underexplored. Objective: To evaluate and compare the effects of perturbation-based physiotherapy and trunk control training on spinal alignment, balance, and functional outcomes in children with CP. Methods: A randomized clinical trial was conducted including children with spastic CP allocated to either perturbation training or trunk control training. Both groups received structured sessions over six weeks. Primary outcomes included the Trunk Control Measurement Scale (TCMS), Pediatric Balance Scale (PBS), Lower Extremity Functional Scale (LEFS), and radiographic spinal alignment. Data were analyzed using appropriate inferential statistics with p < 0.05 as the threshold for significance. Results: Both interventions improved postural stability and function; however, trunk control training resulted in significantly greater improvements across all measures. The between-group differences favored trunk control for TCMS, PBS, LEFS, and spinal alignment (all p < 0.05). Conclusion: Trunk control training demonstrated superior efficacy over perturbation training, supporting its prioritization in pediatric CP rehabilitation to enhance functional mobility and independence.