Investigating rehabilitation by activities involving the trunk to improve balance and gait control in young children with cerebral palsy: a randomized open-label crossover trial protocol

IntroductionChildren with cerebral palsy (CP) have gross motor and balance disorders altering standing, walking and activities. Since trunk control is central for balance, rehabilitation targeting the trunk is developing. In children with CP aged 5 to 12 years, rehabilitation by activities involving the trunk (RAIT) based on activities in intermediate postures for 3 months has been demonstrated to significantly improve trunk control while standing and early trunk deceleration and coupled negative ankle power due to plantar flexors while walking autonomously. As motor disorders develop early, the effects of RAIT are investigated in younger children and for longer time: the adapted design of this study is presented. Initial motor disorders in children with CP aged 18 months to 5 years and 6 months, compared with typically developing children, are expected to be better reduced after RAIT during its first 3 months application than after usual rehabilitation, and to be increasingly reduced after 3, 6 and 12 months of RAIT. MethodsThe studied motor disorders include -1-during gait, excessive early anterior deceleration of the sternum (primary outcome) measured by inertial measurement unit, excessive anterior location of center of pressure on affected leg(s), excessive enhanced gait variability index and step width measured by a walkway equipped with pressure sensors, -2-Altered gross motor, balance and trunk function measured by the item set version of the Gross Motor Function Measurement 66 and by the Early Clinical Assessment of Balance. Expected resultsAll these variables would be influenced by trunk balance and control, and therefore reduced after RAIT. Trial registrationClinicalTrials.gov ID: NCT06438432 What this paper adds?O_LIBalance control is essential in motor control with a central role of the trunk. C_LIO_LIChildren with cerebral palsy (CP) have motor, balance and trunk deficits. C_LIO_LIA trunk-focused rehabilitation by activities in intermediate postures presented (RAIT). C_LIO_LIStudy design to assess the long-term effects of RAIT in young children with CP. C_LIO_LIRAIT would improve trunk and foot dynamics during gait and gross motor function. C_LI