Correlation of Postural Control with Gross Motor Function in Children with Spastic Cerebral Palsy: An Analytical Cross-Sectional Study
Postural Control and Gross Motor Function in Spastic Cerebral Palsy
Keywords:
Cerebral Palsy, Child, Motor Skills, Physical Therapy Modalities, Postural BalanceAbstract
Background: Poor postural control limits gross motor function in children with spastic cerebral palsy (CP), the most common subtype. In Pakistan, many children reach rehabilitation services at Gross Motor Function Classification System (GMFCS) levels III–V, yet local data on gross motor change during postural-control-focused physiotherapy are scarce. This study assessed the association between postural-control-focused physiotherapy and gross motor function in children with spastic CP.
Methods: This analytical cross-sectional study reviewed clinical records from four pediatric rehabilitation centers in Karachi, Pakistan. Through purposive sampling, records of 60 children aged 4–14 years with spastic CP (GMFCS III–V) and two Gross Motor Function Measure-88 (GMFM-88) assessments six months apart were analyzed. Pre–post change was tested with a paired-samples t-test, and its association with clinically meaningful improvement (>40%) with point-biserial correlation.
Results: Of the 60 children, 32 (53.3%) were boys. The mean GMFM-88 score increased from 11.40 ± 11.27 to 44.90 ± 20.24 (mean change 33.49; 95% CI 29.40–37.59; p < 0.001; d = 2.11). GMFM-88 change correlated positively with improvement >40% (r = 0.370; p = 0.004). Overall, 41 children (68.3%) improved by more than 40%, with no significant difference between age groups (62.9% vs 76.0%; p = 0.281).
Conclusion: Children with spastic CP receiving postural-control-focused physiotherapy made large gross motor gains over six months, and these gains were moderately associated with clinically meaningful improvement regardless of age. Controlled studies with direct postural control measures are needed.
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