Klinik Araştırma
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EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY

Yıl 2025, Cilt: 36 Sayı: 2, 153 - 163, 22.09.2025
https://doi.org/10.21653/tjpr.1377555

Öz

Purpose: Children with cerebral palsy (CP) exhibit varying degrees of impairments that affect the patient’s mobility and ability to perform activities of daily living. It restricts the patient’s capacity to stay balanced and increase energy expenditure. Although the benefits of regular exercise for patients with CP are known, there is a need for more studies, which deal with the effects of different exercise approaches in them. Therefore, the aim of the present study is to investigate the effects of Pilates on sit-to-stand (STS) movement patterns, balance and fatigue in ambulatory children with CP.
Methods: Present study was a randomised controlled trial which was conducted at the Ved Special School, Sampoorna Special School, Abhyaas Special School in Delhi and the SGT Medical College Hospital and Research Institute in Gurugram, Haryana from October 2022 to March 2023. Thirty-two children (7-12 years) with spastic diplegic CP and Gross Motor Function Classification System I and II were randomly assigned into two groups. The study group underwent pilates and conventional treatment and the control group received conventional treatment alone. Images of the subjects’ STS movement pattern were shot from the side through a camera, and 15 items were used to assess the condition of the subjects’ extremities. Balance and fatigue were measured with Pediatric Balance Scale and Modified Borg Scale respectively at baseline, 4th week and 8th week.
Results: Significant improvements were observed in STS movement pattern in the pilates group. Significantly, greater improvements were also observed for other variables such as balance and fatigue (p<0.001) in response to adding pilates exercise program to conventional treatment versus conventional treatment alone.
Conclusion: Children with diplegic CP benefit more from pilates exercises in addition to conventional therapy when it comes to improving their functional movements and fatigue than from conventional therapy alone.

Kaynakça

  • Levitt S, Addison A. Treatment of cerebral palsy and motor delay. John Wiley & Sons; 2018 Nov 28.
  • Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. Am Fam Physician. 2020;101(4):213-20.
  • Da Costa CS, Rocha NA. Sit-to-stand movement in children: a longitudinal study based on kinematics data. Hum Mov Sci. 2013;32(4):836-46.
  • Suriyaamarit D, Boonyong S. Mechanical work, kinematics, and kinetics during sit-to-stand in children with and without spastic diplegic cerebral palsy. Gait Posture. 2019;67:85-90.
  • Pavão SL, Santos AN, Oliveira AB, Rocha NA. Postural control during sit-to-stand movement and its relationship with upright position in children with hemiplegic spastic cerebral palsy and in typically developing children. Braz J Phys Ther. 2015;19(1):18-25.
  • Gupta A, Sen S. The effect of pelvic control exercises on standing posture in children with spastic diplegic cerebral palsy: a pilot randomized controlled trial. Turk J Physiother Rehabil. 2025;36:20-40.
  • Balemans AC, van Wely L, Becher JG, Dallmeijer AJ. Longitudinal relationship among physical fitness, walking-related physical activity, and fatigue in children with cerebral palsy. Physical Therapy. 2015;95(7):996-1005.
  • Tarakci D, Ozdincler AR, Tarakci E, Tutuncuoglu F, Ozmen M. Wii-based balance therapy to improve balance function of children with cerebral palsy: a pilot study. J Phys Ther Sci. 2013;25(9):1123-7.
  • Lowes LP, Westcott SL, Palisano RJ, Effgen SK, Orlin MN. Muscle force and range of motion as predictors of standing balance in children with cerebral palsy. Phys Occup Ther Pediatr. 2004;24(1-2):57-77.
  • Hornsby E, Johnston LM. Effect of pilates intervention on physical function of children and youth: a systematic review. Arch Phys Med Rehabil. 2020;101(2):317-28.
  • O’Shea R, Siconolfi-Morris G. Complementary therapy approaches for children and youth with cerebral palsy. Cerebral Palsy. 2020:3069-81.
  • Dos Santos AN, Serikawa SS, Rocha NA. Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study. Dev Neurorehabil. 2016;19(4):226-30.
  • Schmidt SA, Lo S, Hollestein LM. Research techniques made simple: sample size estimation and power calculation. J Invest Dermatol. 2018;138(8):1678-82.
  • Ghotbi N, Nakhostin Ansari N, Naghdi S, Hasson S. Measurement of lower-limb muscle spasticity: intrarater reliability of Modified Modified Ashworth Scale. J Rehabil Res Dev. 2011;48(1):83-8.
  • Palisano RJ, Avery L, Gorter JW, Galuppi B, McCoy SW. Stability of the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System. Dev Med Child Neurol. 2018;60(10):1026-32.
  • Yonetsu R, Nitta O, Surya J. “Patternizing” standards of sit-to-stand movements with support in cerebral palsy. NeuroRehabilitation. 2009;25(4):289-96.
  • Nuzik S, Lamb R, VanSant A, Hirt S. Sit-to-stand movement pattern. A kinematic study. Phys Ther. 1986;66(11):1708-13.
  • Park ES, Park CI, Lee HJ, Kim DY, Lee DS, Cho SR. The characteristics of sit-to-stand transfer in young children with spastic cerebral palsy based on kinematic and kinetic data. Gait Posture. 2003;17(1):43-9.
  • Chen CL, Shen IH, Chen CY, Wu CY, Liu WY, Chung CY. Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy. Res Dev Disabil. 2013;34(3):916-22.
  • Maltais D, Wilk B, Unnithan V, Bar-Or O. Responses of children with cerebral palsy to treadmill walking exercise in the heat. Med Sci Sports Exerc. 2004;36(10):1674-81.
  • Robert M, Ballaz L, Hart R, Lemay M. Exercise intensity levels in children with cerebral palsy while playing with an active video game console. Phys Ther. 2013;93(8):1084-91.
  • Gutner K. The Pilates essential repertoire. Art of motion, 19 edition. 2013:96-208.
  • Pavão SL, Dos Santos AN, de Oliveira AB, Rocha NA. Functionality level and its relation to postural control during sitting-to-stand movement in children with cerebral palsy. Res Dev Disabil. 2014;35(2):506-11.
  • Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates training on lumbo-pelvic stability and flexibility. Asian J Sports Med. 2011;2(1):16-22.
  • Niaradi FDSL, Niaradi MFDSL, Gasparetto MERF. Effect of eutonia, holistic gymnastics, and pilates on body posture for pre-adolescent girls: randomized clinical trial. J Bodyw Mov Ther. 2022;30:226-36.
  • Panibatla S, Kumar V, Narayan A. Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. J Clin Diagn Res. 2017;11(9):YC05-8.
  • Suner-Keklik S, Numanoglu-Akbas A, Cobanoglu G, Kafa N, Guzel NA. An online pilates exercise program is effective on proprioception and core muscle endurance in a randomized controlled trial. Ir J Med Sci. 2022;191(5):2133-9.
  • Dos Santos AN, Serikawa SS, Rocha NA. Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study. Dev Neurorehabil. 2016;19(4):226-30.
  • Adıguzel H, Elbasan B. Effects of modified pilates on trunk, postural control, gait and balance in children with cerebral palsy: a single-blinded randomized controlled study. Acta Neurol Bel. 2022;122(4):903-14.
  • Abd-Elfattah HM, Galal DOSM, Aly MIE, Aly SM, Elnegamy TE. Effect of pilates exercises on standing, walking, and balance in children with diplegic cerebral palsy. Ann Rehabil Med. 2022;46(1):45-52.
  • Değer Ü, Mutlu A. An investigation of relationship between trunk and lower extremity muscle strength and functional activity in children with spastic cerebral palsy. Turk J Physiother Rehabil. 2020;31(3):225-32.
  • Soysal Tomruk M, Uz MZ, Kara B, İdiman E. Effects of pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis. Mult Scler Relat Disord. 2016;7:70-3.

PİLATES’İN SPASTİK DİPLEJİK SEREBRAL PALSİLİ ÇOCUKLARDA HAREKET DÜZENLERİ, DENGE VE YORGUNLUK DÜZEYİ ÜZERİNE ETKİSİ

Yıl 2025, Cilt: 36 Sayı: 2, 153 - 163, 22.09.2025
https://doi.org/10.21653/tjpr.1377555

Öz

Amaç: Serebral palsili (SP) çocuklarda, hareket kabiliyetini ve günlük yaşam aktivitelerini yerine getirme becerisini etkileyen farklı derecelerde bozukluklar görülmektedir. Bu durum, hastanın dengede kalma kapasitesini kısıtlamakta ve enerji harcamasını artırmaktadır. SP’li bireylerde düzenli egzersizin faydaları bilinmesine rağmen, farklı egzersiz yaklaşımlarının etkilerini ele alan daha fazla çalışmaya ihtiyaç vardır. Bu nedenle, bu çalışmanın amacı, ayaktan tedavi gören SP’li çocuklarda Pilates’in otur-kalk (STS) hareket paternleri, denge ve yorgunluk üzerindeki etkilerini araştırmaktır.
Yöntem: Bu çalışma, Ekim 2022’den Mart 2023’e kadar Delhi’deki Ved Özel Okulu, Sampoorna Özel Okulu, Abhyaas Özel Okulu ve Gurugram, Haryana’daki SGT Tıp Koleji Hastanesi ve Araştırma Enstitüsü’nde gerçekleştirilen randomize kontrollü bir araştırmadır. Spastik diplejik SP’li ve Kaba Motor Fonksiyon Sınıflandırma Sistemi I ve II düzeyinde olan otuz iki çocuk (7–12 yaş) rastgele iki gruba ayrılmıştır. Çalışma grubuna pilates egzersizleri ve konvansiyonel tedavi, kontrol grubuna ise yalnızca konvansiyonel tedavi uygulanmıştır. Deneklerin STS hareket paternleri bir kamera aracılığıyla yandan kaydedilmiş ve ekstremitelerin durumunu değerlendirmek için 15 madde kullanılmıştır. Denge ve yorgunluk, sırasıyla başlangıçta, 4. haftada ve 8. haftada Pediatrik Denge Ölçeği ve Modifiye Borg Ölçeği ile ölçülmüştür.
Bulgular: Pilates grubunda STS hareket paterninde anlamlı iyileşmeler gözlenmiştir. Ayrıca, konvansiyonel tedaviye pilates egzersiz programının eklenmesiyle, yalnızca konvansiyonel tedaviye kıyasla denge ve yorgunluk gibi diğer değişkenlerde de daha belirgin iyileşmeler elde edilmiştir (p<0,001).
Sonuç: Diplejik SP’li çocuklar, fonksiyonel hareketlerini geliştirme ve yorgunluğu azaltma açısından yalnızca konvansiyonel terapiye göre, pilates egzersizlerinin de dahil edildiği tedavilerden daha fazla yarar sağlamaktadır.

Kaynakça

  • Levitt S, Addison A. Treatment of cerebral palsy and motor delay. John Wiley & Sons; 2018 Nov 28.
  • Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. Am Fam Physician. 2020;101(4):213-20.
  • Da Costa CS, Rocha NA. Sit-to-stand movement in children: a longitudinal study based on kinematics data. Hum Mov Sci. 2013;32(4):836-46.
  • Suriyaamarit D, Boonyong S. Mechanical work, kinematics, and kinetics during sit-to-stand in children with and without spastic diplegic cerebral palsy. Gait Posture. 2019;67:85-90.
  • Pavão SL, Santos AN, Oliveira AB, Rocha NA. Postural control during sit-to-stand movement and its relationship with upright position in children with hemiplegic spastic cerebral palsy and in typically developing children. Braz J Phys Ther. 2015;19(1):18-25.
  • Gupta A, Sen S. The effect of pelvic control exercises on standing posture in children with spastic diplegic cerebral palsy: a pilot randomized controlled trial. Turk J Physiother Rehabil. 2025;36:20-40.
  • Balemans AC, van Wely L, Becher JG, Dallmeijer AJ. Longitudinal relationship among physical fitness, walking-related physical activity, and fatigue in children with cerebral palsy. Physical Therapy. 2015;95(7):996-1005.
  • Tarakci D, Ozdincler AR, Tarakci E, Tutuncuoglu F, Ozmen M. Wii-based balance therapy to improve balance function of children with cerebral palsy: a pilot study. J Phys Ther Sci. 2013;25(9):1123-7.
  • Lowes LP, Westcott SL, Palisano RJ, Effgen SK, Orlin MN. Muscle force and range of motion as predictors of standing balance in children with cerebral palsy. Phys Occup Ther Pediatr. 2004;24(1-2):57-77.
  • Hornsby E, Johnston LM. Effect of pilates intervention on physical function of children and youth: a systematic review. Arch Phys Med Rehabil. 2020;101(2):317-28.
  • O’Shea R, Siconolfi-Morris G. Complementary therapy approaches for children and youth with cerebral palsy. Cerebral Palsy. 2020:3069-81.
  • Dos Santos AN, Serikawa SS, Rocha NA. Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study. Dev Neurorehabil. 2016;19(4):226-30.
  • Schmidt SA, Lo S, Hollestein LM. Research techniques made simple: sample size estimation and power calculation. J Invest Dermatol. 2018;138(8):1678-82.
  • Ghotbi N, Nakhostin Ansari N, Naghdi S, Hasson S. Measurement of lower-limb muscle spasticity: intrarater reliability of Modified Modified Ashworth Scale. J Rehabil Res Dev. 2011;48(1):83-8.
  • Palisano RJ, Avery L, Gorter JW, Galuppi B, McCoy SW. Stability of the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System. Dev Med Child Neurol. 2018;60(10):1026-32.
  • Yonetsu R, Nitta O, Surya J. “Patternizing” standards of sit-to-stand movements with support in cerebral palsy. NeuroRehabilitation. 2009;25(4):289-96.
  • Nuzik S, Lamb R, VanSant A, Hirt S. Sit-to-stand movement pattern. A kinematic study. Phys Ther. 1986;66(11):1708-13.
  • Park ES, Park CI, Lee HJ, Kim DY, Lee DS, Cho SR. The characteristics of sit-to-stand transfer in young children with spastic cerebral palsy based on kinematic and kinetic data. Gait Posture. 2003;17(1):43-9.
  • Chen CL, Shen IH, Chen CY, Wu CY, Liu WY, Chung CY. Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy. Res Dev Disabil. 2013;34(3):916-22.
  • Maltais D, Wilk B, Unnithan V, Bar-Or O. Responses of children with cerebral palsy to treadmill walking exercise in the heat. Med Sci Sports Exerc. 2004;36(10):1674-81.
  • Robert M, Ballaz L, Hart R, Lemay M. Exercise intensity levels in children with cerebral palsy while playing with an active video game console. Phys Ther. 2013;93(8):1084-91.
  • Gutner K. The Pilates essential repertoire. Art of motion, 19 edition. 2013:96-208.
  • Pavão SL, Dos Santos AN, de Oliveira AB, Rocha NA. Functionality level and its relation to postural control during sitting-to-stand movement in children with cerebral palsy. Res Dev Disabil. 2014;35(2):506-11.
  • Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates training on lumbo-pelvic stability and flexibility. Asian J Sports Med. 2011;2(1):16-22.
  • Niaradi FDSL, Niaradi MFDSL, Gasparetto MERF. Effect of eutonia, holistic gymnastics, and pilates on body posture for pre-adolescent girls: randomized clinical trial. J Bodyw Mov Ther. 2022;30:226-36.
  • Panibatla S, Kumar V, Narayan A. Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. J Clin Diagn Res. 2017;11(9):YC05-8.
  • Suner-Keklik S, Numanoglu-Akbas A, Cobanoglu G, Kafa N, Guzel NA. An online pilates exercise program is effective on proprioception and core muscle endurance in a randomized controlled trial. Ir J Med Sci. 2022;191(5):2133-9.
  • Dos Santos AN, Serikawa SS, Rocha NA. Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study. Dev Neurorehabil. 2016;19(4):226-30.
  • Adıguzel H, Elbasan B. Effects of modified pilates on trunk, postural control, gait and balance in children with cerebral palsy: a single-blinded randomized controlled study. Acta Neurol Bel. 2022;122(4):903-14.
  • Abd-Elfattah HM, Galal DOSM, Aly MIE, Aly SM, Elnegamy TE. Effect of pilates exercises on standing, walking, and balance in children with diplegic cerebral palsy. Ann Rehabil Med. 2022;46(1):45-52.
  • Değer Ü, Mutlu A. An investigation of relationship between trunk and lower extremity muscle strength and functional activity in children with spastic cerebral palsy. Turk J Physiother Rehabil. 2020;31(3):225-32.
  • Soysal Tomruk M, Uz MZ, Kara B, İdiman E. Effects of pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis. Mult Scler Relat Disord. 2016;7:70-3.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fizyoterapi
Bölüm Araştırma Makaleleri
Yazarlar

Aartı Gupta 0000-0003-0637-8656

Ashirwad Dass

Vinika Chaudhary

Pooja Bhati Bu kişi benim 0000-0002-9968-7994

Yayımlanma Tarihi 22 Eylül 2025
Gönderilme Tarihi 19 Ekim 2023
Kabul Tarihi 21 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 36 Sayı: 2

Kaynak Göster

APA Gupta, A., Dass, A., Chaudhary, V., Bhati, P. (2025). EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 36(2), 153-163. https://doi.org/10.21653/tjpr.1377555
AMA Gupta A, Dass A, Chaudhary V, Bhati P. EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY. Turk J Physiother Rehabil. Eylül 2025;36(2):153-163. doi:10.21653/tjpr.1377555
Chicago Gupta, Aartı, Ashirwad Dass, Vinika Chaudhary, ve Pooja Bhati. “EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY”. Türk Fizyoterapi ve Rehabilitasyon Dergisi 36, sy. 2 (Eylül 2025): 153-63. https://doi.org/10.21653/tjpr.1377555.
EndNote Gupta A, Dass A, Chaudhary V, Bhati P (01 Eylül 2025) EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY. Türk Fizyoterapi ve Rehabilitasyon Dergisi 36 2 153–163.
IEEE A. Gupta, A. Dass, V. Chaudhary, ve P. Bhati, “EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY”, Turk J Physiother Rehabil, c. 36, sy. 2, ss. 153–163, 2025, doi: 10.21653/tjpr.1377555.
ISNAD Gupta, Aartı vd. “EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY”. Türk Fizyoterapi ve Rehabilitasyon Dergisi 36/2 (Eylül2025), 153-163. https://doi.org/10.21653/tjpr.1377555.
JAMA Gupta A, Dass A, Chaudhary V, Bhati P. EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY. Turk J Physiother Rehabil. 2025;36:153–163.
MLA Gupta, Aartı vd. “EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY”. Türk Fizyoterapi ve Rehabilitasyon Dergisi, c. 36, sy. 2, 2025, ss. 153-6, doi:10.21653/tjpr.1377555.
Vancouver Gupta A, Dass A, Chaudhary V, Bhati P. EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY. Turk J Physiother Rehabil. 2025;36(2):153-6.