  Introduction There is increasing focus on the association between trunk
control and functional abilities in children with cerebral palsy (CP). The
purpose of this study was to determine the extent of functional change in
children with CP who participated in specific trunk and head postural control
training combined with physical therapy treatment as usual (TAU).
  Methods This study included 140 consecutive referrals to a centre
specialising in head and trunk postural control (Targeted Training (TT))
between 2009 and 2016. Twenty-five children discontinued therapy due to
surgery, health, family issues or poor attendance. The remaining 115 children
(46 girls, 69 boys) had a mean age of 6 y 6 mo (SD 2 y 8 mo) with participants
from all GMFCS levels. The intervention was a program of TT and ongoing TAU
with a mean duration of 11 months. Gross Motor Function Measure (GMFM),
Pediatric Evaluation of Disability Inventory functional skills, Chailey Levels
of Ability and Segmental Assessment of Trunk Control were administered before
and after the intervention.
  Results There were significant improvements in all outcomes. GMFM
improvements exceeded those predicted from the published reference curves,
especially for the children with more severe cerebral palsy.
  Conclusions Functional improvement exceeded the expected norm, especially in
those children with more severe gross motor function disability. The other
outcomes also showed significant improvements. These findings support the case
for further studies and, if needed, tool development to facilitate
determination of the critical elements in a combined therapy approach of TT
with TAU.

Quantitative Methods;Tissues and Organs