The effect of trunk position sense and trunk control on lower extremity functionally in children with cerebral palsy

Inadequate postural control in children with Cerebral Palsy (CP) also negatively affects trunk control and trunk position sense, and also affects the functional activities we perform during daily life. Lower extremity functionality is also affected by inadequate postural control. In this case, it is important to examine the relationship between trunk position sense and trunk control and lower extremity functions in children with CP. The aim of this study is to examine the effects of trunk position sense and trunk control on lower extremity functionality in children with Cerebral Palsy. Twenty-five children with a diagnosis of CP between the ages of 7-17 and Gross Motor Function Classification System level I-II were included in the study. Demographic and physical characteristics of the children were recorded. The trunk control of the children participating in the study was evaluated with the Trunk Control Measurement Scale (TCMS) and the Trunk Impairment Scale (TIS), and the sense of trunk position was evaluated with the Goniometer Pro application on the phone. In order to evaluate the lower extremity functionality of the children, the Timed Up and Go Test (TUG), Stair Climb Test (SCT) and 1 Minute Walk Test (1MWT) which are among the functional mobility tests, and the 30 Seconds Sit To Stand Test, and Step Up Test and Lateral Step Up Test which are among the functional muscle strength tests, were used. The levels of independence and participation in activities of daily living were evaluated with the Pediatric Functional Independence Measure (WeEFIM). According to the findings of the study, there was a significant relationship between all parameters of GKSS and KMFSS levels in children with CP, while a significant relationship was found between GES and KMFSS levels only in the GES static sitting balance sub-score (p<0.05). In addition, significant correlations were found between children's KMFSS levels and trunk position sense, lower extremity functionality and functional independence level (p<0.05). While trunk control was found to be effective on lower extremity functionality, it was not found to be associated with functional independence. Trunk position sense had no effect on lower extremity functionality and functional independence (p>0.05). In conclusion, trunk control was the determinant of lower extremity functionality in children with CP, but trunk position sense was not. During physiotherapy and rehabilitation practices and evaluations, not ignoring trunk position sense and trunk control will make important contributions to lower extremity functionality and functional independence.