Comparative Efficacy of Swiss Ball and Spider Cage Therapies on Trunk Control and Functional Balance in Children with Diplegic Cerebral Palsy: A Randomized Controlled Trial

Context: Spastic diplegia is a common subtype of cerebral palsy (CP) and is frequently associated with impaired trunk control, leading to deficits in balance and functional activities. Improving trunk stability is a key component of rehabilitation in children with spastic diplegic CP. Aims and Objectives: To compare the effectiveness of Swiss ball exercises and Spider cage suspension therapy, when combined with conventional physiotherapy, on trunk control and functional balance in children with spastic diplegic CP. Settings and Design: A randomized controlled trial conducted at VAPMS College of Physiotherapy and RK Mission, Visakhapatnam. Subjects and Methods: Thirty children aged 6–12 years with spastic diplegic CP (Gross Motor Function Classification System Levels I–III) were randomly allocated into two groups. Group A received Swiss ball exercises along with conventional physiotherapy, while Group B received Spider cage suspension therapy along with conventional physiotherapy. Interventions were administered three times per week for 6 weeks. Trunk control and balance were assessed using the trunk control measurement scale (TCMS) and the pediatric balance scale (PBS) before and after the intervention. Statistical analysis: Paired t -test was used for within-group analysis and unpaired t -test for between-group comparison. A P < 0.05 was considered statistically significant. Results: Both groups showed statistically significant improvements in TCMS static, TCMS dynamic, and PBS scores following the intervention ( P < 0.05). However, the Spider cage therapy group demonstrated greater improvement compared to the Swiss ball group. Conclusion: Spider cage suspension therapy, by providing enhanced vestibular, proprioceptive, and visual feedback, is superior to Swiss ball exercises in enhancing trunk control and functional balance in children with spastic diplegic CP. These findings support the incorporation of Spider cage therapy into rehabilitation protocols to improve proximal stability and balance in this population.