Preliminary Changes in Head Control and Segmental Trunk Control Following an Eight-Week Core Strengthening Program in Children with Bilateral Spastic Cerebral Palsy

Background: Children with bilateral spastic cerebral palsy classified at the more severe levels of the Gross Motor Function Classification System (GMFCS) exhibit profound deficits in head and trunk control that constrain functional independence, feeding safety, and caregiver burden. Objective: To characterize within-subject changes in head control and segmental trunk control following an eight-week, manualized, therapist-supervised core muscle strengthening program in children with bilateral spastic cerebral palsy at GMFCS levels IV and V. Methods: A single-arm quasi-experimental study with within-subject assessments at baseline, mid-intervention, and post-intervention (week 8) was conducted. Following removal of two participants at the data-cleaning stage for a baseline eligibility deviation, 36 children aged 4–10 years received a structured core strengthening program delivered three times weekly for eight consecutive weeks (24 sessions total, 45–50 min each). The two standardized outcome measures were the Head Control Scale (HCS) and the Segmental Assessment of Trunk Control (SATCo), the latter analyzed as Static subscale, Active subscale, and Total composite. Results: Statistically significant improvement over time was observed on every outcome (all Friedman p < 0.001; Kendall’s W range 0.813–0.950), and every pairwise interval comparison was significant after Bonferroni adjustment. Pre-to-post change reached large to very large effect sizes. As a secondary robustness check, one-way repeated-measures analysis of variance corroborated effects of time on the HCS and the SATCo Static and Total composites (all p < 0.001; partial η2 range 0.722–0.792). Conclusions: These preliminary findings suggest that the program is feasible and associated with statistically significant within-subject improvements in head and trunk control in children with bilateral spastic cerebral palsy at GMFCS levels IV and V. Because the study had no control group, outcomes were confined to the body-functions level, and maintenance was not assessed, causal inference and translation to activity and participation remain undetermined; controlled trials with follow-up are required to determine efficacy.