A PRELIMINARY-REPORT ON THE EFFECTIVENESS OF TRUNK TARGETING IN ACHIEVING INDEPENDENT SITTING BALANCE IN CHILDREN WITH CEREBRAL-PALSY

Objective: To assess the potential of Targeted Training in initiating or accelerating improved movement control of the trunk and hip joints in children with cerebral palsy so that independent sitting balance wi thout specialized seating could be achieved. Design: Six single case s tudies. Setting: Assessment and review were undertaken in a specialize d centre with intervention in the subjects' home or school. Subjects: Children between the ages of two years five months and seven years fiv e months (mean four years seven months) with an established diagnosis of cerebral palsy. None had independent sitting balance at the start o f the study. Intervention: Targeted Training using specialized equipme nt was directed at the appropriate few joints of the trunk as determin ed by initial resting and progressed when control at those joints had become automatic. The equipment provided support and challenged contro l learning. Periods of no intervention and placebo intervention, when the equipment was inappropriately set up, were also used. Two of the c hildren ceased their traditional physiotherapy input while Targeted Tr aining or placebo training took place. Main outcome measure: A new tes t was devised and validated to determine the most caudal extent of con trol of the vertical posture. in addition, a functional test of indepe ndent sitting balance was defined. Results: Ali six children showed an increase in movement control and all gained independent sitting balan ce within 12-25 weeks (mean 16 weeks). This was irrespective of the co ntinuation or cessation of traditional physiotherapy. Conclusion: Thes e preliminary findings suggest that Targeted Training may be an effect ive means of promoting movement control and functional ability. Confir mation of these findings by other investigators would be of value.