Effects of Reflex Mediated Core Stability Exercise on Sensory Processing Skills and Gross Motor Function

Reflex-mediated core stabilization, also known as dynamic neuromuscular stabilization (DNS). Dynamic Neuromuscular Stabilization (DNS) is a rehabilitation approach based on developmental kinesiology, which observes infant motor behavior from birth to walking. Proposed by Pavel Kolar, it emphasizes posture, breathing patterns, and joint centration, focusing on core stability provided by muscles such as the diaphragm, transverse abdominis, and multifidus. DNS aims to improve muscle strength and endurance by enhancing neuromuscular coordination and integrating the spinal stabilization system. Cerebral Palsy (CP) is a neurodevelopmental disorder affecting posture and mobility due to non-progressive brain lesions, often presenting with abnormal muscle tone, weakness, poor trunk control, and sensory, perceptual, communication, and cognitive issues. Sensory-processing disorders are frequently observed in children with CP. While traditional core stability exercises and sensory integration therapies have shown benefits, this study aims to specifically investigate the comprehensive impact of reflex-mediated core stability exercises (DNS) on both sensory processing skills and overall gross motor function in children with CP.

The study design will be Randomized Controlled Trial, conducted over 10 months at Sehat Medical Complex in Lahore. A total of 26 participants, with 13 in each group, will be recruited using non-probability convenient sampling. Inclusion criteria include children aged 4-12 years diagnosed with spastic-type CP (diplegic) classified within GMFCS Levels III-V who can follow simple verbal instructions, and whose legal guardian provides informed consent. Exclusion criteria encompass severe cognitive impairment, severe muscle contracture >10 degrees or bone deformity, and significant communication deficits. Data will be collected using the Sensory Profiling (SP) and Gross Motor Function Measure-88 (GMFM-88) tools. The experimental Group A will receive 30 minutes of reflex-mediated core stabilization exercises five times weekly, followed by 20 minutes of conventional therapy for 8 weeks. Group B, the control group, will receive conventional therapy. The synopsis will be presented to the Research Ethical Committee of Riphah International University, Lahore, for ethical approval to conduct this study. Data will be analyzed through SPSS version 27.0

Inclusion criteria

• Children with both genders.
• Children diagnosed with Cerebral Palsy (CP).
• Children aged between 4-12 years (12).
• Children with spastic-type Cerebral Palsy (diplegic) classified within Gross Motor Function Classification System (GMFCS) Levels III-V.
• Ability to understand and consistently follow simple verbal instructions.
• Informed written consent obtained from the child's legal parent or guardian.

Exclusion criteria

• Children with severe cognitive impairment.
• Severe muscle contracture >10 degrees or bone deformity significantly limiting participation in exercises.
• Children with significant Communication Deficits
• Any operational procedure within the last six months