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

July 27, 2026 updated by: Riphah International University

Effects of Reflex Mediated Core Stability Exercise on Sensory Processing Skills and Gross Motor Function in Children With Cerebral Palsy

Current literature on DNS in CP primarily focuses on motor outcomes like postural control and balance. Therefore, there are fewer studies up to researcher's knowledge about DNS's impact on broad sensory processing skills in CP. The study will investigate the direct effect of reflex-mediated core stability exercises on a comprehensive range of sensory processing skills in children with CP.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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

Study Type

Interventional

Enrollment (Actual)

26

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
      • Lahore, Pakistan
        • Sehat Medical Complex Hanjarwal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Reflex mediated core stability exercise

the exercises are progressed over the six weeks and include positions such as:

  • Supine Lying
  • Prone Position
  • Side Lying Position
  • Quadripod Positio
  • Tripod Position
  • Squat
Other: Reflex mediated core stability exercise

The exercises are progressed over the six weeks and include positions such as:

  • Supine Lying
  • Prone Position
  • Side Lying Position
  • Quadripod Position
  • Tripod Position
  • Squat
Other: conventional therapy

Participants will be given 20 min of conventional therapy for 8 weeks, five times weekly.

Therapy includes:

Facilitatory techniques are used for gross motor control such as:

  • Quadruped activities
  • Crawling
  • Kneeling
  • Sitting
  • Walking

It also incorporates exercises like:

  • Passive stretches for adductors, hamstrings, quadriceps, and calf muscles in both limbs (three repetitions with a 10-second hold).
  • Active and passive range-of-motion exercises for the lower limbs in sitting and supine positions (three sets with 10 repetitions).
Experimental: conventional therapy

Participants will be given 20 min of conventional therapy for 8 weeks, five times weekly.

Therapy includes:

Facilitatory techniques are used for gross motor control such as:

  • Quadruped activities
  • Crawling
  • Kneeling
  • Sitting
  • Walking

It also incorporates exercises like:

  • Passive stretches for adductors, hamstrings, quadriceps, and calf muscles in both limbs (three repetitions with a 10-second hold).
  • Active and passive range-of-motion exercises for the lower limbs in sitting and supine positions (three sets with 10 repetitions).
Other: conventional therapy

Participants will be given 20 min of conventional therapy for 8 weeks, five times weekly.

Therapy includes:

Facilitatory techniques are used for gross motor control such as:

  • Quadruped activities
  • Crawling
  • Kneeling
  • Sitting
  • Walking

It also incorporates exercises like:

  • Passive stretches for adductors, hamstrings, quadriceps, and calf muscles in both limbs (three repetitions with a 10-second hold).
  • Active and passive range-of-motion exercises for the lower limbs in sitting and supine positions (three sets with 10 repetitions).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sensory processing skills
Time Frame: baseline and after 6 weeks
Sensory profiling was designed by an occupational therapist. The questionnaire assessing the sensory processing of children aged 3-10 was filled out by their parents or caregivers. It consisted of 125 items. The survey consisted of 14 subsections under 3 main headings. These main topics were sensory processing, modulation, and emotional behavioral responses.
baseline and after 6 weeks
Gross motor function
Time Frame: baseline and after 6 weeks
The Gross Motor Function Measure (GMFM) is a tool that has been developed to assess change in gross motor function in children with cerebral palsy aged 5 months to 16 years of age.
baseline and after 6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Saifah Ashfaq, dpt, ripah international university

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2026

Primary Completion (Actual)

July 20, 2026

Study Completion (Actual)

July 27, 2026

Study Registration Dates

First Submitted

May 5, 2026

First Submitted That Met QC Criteria

July 27, 2026

First Posted (Actual)

July 28, 2026

Study Record Updates

Last Update Posted (Actual)

July 28, 2026

Last Update Submitted That Met QC Criteria

July 27, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0705

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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