The Role of Trunk Control on Hand Function, Activities of Daily Living, and Quality of Life in Children with Cerebral Palsy

Purpose: This study aims to evaluate the impact of trunk control on hand function, daily living activities, and quality of life in children with hemiparetic and diparetic Cerebral Palsy (CP). Methods: We included 46 ambulatory children with CP classified at Gross Motor Function Classification System levels I-III. Children were divided into two groups based on the median Trunk Control Measurement Scale (TCMS) score (42.50): those with higher trunk control (Group 1, n = 23) and those with lower trunk control (Group 2, n = 23). We evaluated their hand function using 9-Hole Peg Test (9-HPT), activities of daily living (ADLs) using Functional Independence Measure for Children (WeeFIM), and quality of life using Pediatric Quality of Life Inventory (PedsQL). Results: Children with higher trunk control demonstrated significantly better 9-HPT dominant hand function (p=0.005) and higher scores in WeeFIM (p=0.001) compared to those with lower trunk control. Moderate to low positive correlations were found between all TCMS parameters and WeeFIM (r=0.455 to 0.568, p<0.01), while 9-HPT dominant hand function showed moderate to low negative correlations with TCMS parameters (r=–0.422 to –0.601, p<0.01). No significant associations were observed with PedsQL parameters or 9-HPT non-dominant hand function (p>0.05). Conclusion: Impaired trunk control was associated with dominant hand function and ADLs, but not with non-dominant hand function or quality of life. Considering its relationship with hand function and ADLs, trunk control should be incorporated into the assessment process.