Effect of Swiss Ball Stabilization Training on Trunk Control, Abdominal Muscle Thickness, Balance, and Motor Skills of Children With Spastic Cerebral Palsy: A Randomized, Superiority Trial

Objectives: To compare the effects of Swiss ball stabilization training (SBST) and stable surface stabilization training (SSST) on the trunk control, abdominal muscle thickness, balance, and motor skills of children with spastic cerebral palsy (CWSCP). Design: Single-blind, randomized superiority trial. Setting: General Community and Referral Center. Participants: Thirty CWSCP, aged 6-12 years, with Gross Motor Function Classification System levels I-III were randomly assigned to the SBST and SSST groups (N=30).Interventions: The participants were randomized to receive either SBST or SSST for 5 weeks, 3 days a week.Outcome Measures: The Trunk Control Measurement Scale (TCMS), abdominal muscle thickness, Pediatric Balance Scale (PBS), standing and walking sections of Gross Motor Function Measure (GMFM-88), and mobility section of the Pediatric Evaluation of Disability Inventory (PEDI) were assessed.Results: After 5 weeks of the intervention and 9 weeks of follow-up, the SBST group showed statistically significant improvements in the TCMS, GMFM-88, PEDI, thickness of the internal oblique muscle at rest and contraction, and thickness of the transverse abdominis muscle at rest and contraction compared with the SSST group (P<.0001). Contrarily, the thickness of the external oblique muscle increased statistically significantly in the SSST group compared with the SBST group after 5 weeks of the intervention and 9 weeks of follow-up both at rest (P<.0001 and P=.0001, respectively) and contraction (P=.015 and P=.017, respectively). No statistically significant difference was found between the groups regarding the PBS score after 5 weeks of intervention. Conclusion: The SBST could improve the trunk control, balance, and motor skills of CWSCP and increase the thickness of local abdominal muscles. Also, SBST was more effective than SSST for CWSCP.