Effectiveness of Dual Task Exercise Training in Children With Cerebral Palsy

Primary outcomes

1. Pediatric Balance Scale (PBS)

   Time frame: Change from Baseline PBS at 12 weeks

   The scale consists of 14 items measuring parameters such as sitting balance and standing balance. Each item is ranked from 0 to 4. 0 indicates that the instruction cannot be fulfilled, while 4 indicates that it can be fulfilled without any difficulty. The maximum total score is 56.

2. Timed Up and Go Test (TUG)

   Time frame: Change from Baseline TUG at 12 weeks

   Participants sit in a chair with arms, hips and knees bent approximately 90◦ and feet resting on the floor. Lower limb orthoses are worn if used. Participants are asked to stand up, walk 10 steps, walk around a mark on the floor, walk back to the chair and sit down. The timing of the TUG test starts with the standing movement after the "ready, go" signal and ends when the participants are seated in the chair and the movement is finished.

3. One Leg Standing Test (OLST)

   Time frame: Change from Baseline OLST at 12 weeks

   Children are tested standing on one leg using their right and left leg respectively. The test is repeated on a hard surface with eyes open and closed. The child is asked to place both hands on the hips and look at a target on the wall at eye level at a distance of 1 meter. The child is asked to stand with one leg while keeping the other leg in a 90 degree flexion position. A stopwatch is used to record the time the child can hold the test position. The examiner ends the test if the child can hold the position for more than 30 seconds and records the elapsed time.

4. 3-Meter Backward Walk Test (3MBWT)

   Time frame: Change from Baseline 3MBWT at 12 weeks

   A distance of 3 m was measured and marked with black tape. Children were asked to follow the black tape with their heels. They were asked to walk backwards quickly with the command 'start'. When the 3 m distance was completed, they were asked to stop. The assessor walked behind the individuals throughout the test.

5. 6 Meter Walk Test (6MWT)

   Time frame: Change from Baseline 6MWT at 12 weeks

   A 6-meter track is determined. Children are asked to walk at a comfortable pace with the command "Start". The stopwatch is stopped by touching the finish line.

6. The Generic Children's Health-Related Quality of Life Questionnaire (KINDL)

   Time frame: Change from Baseline KINDL at 12 weeks

   The KINDL is a self-report questionnaire available for 3 different age groups: Kiddy-KINDL for children aged 4-7 years, Kid-KINDL for children aged 8-12 years and Kiddo-KINDL for adolescents aged 13-16 years. The total score ranges from 0-100. A higher score represents a better situation.