Effects of Core Stability Program on Abdominal Endurance in Wheelchair Bound Cerebral Palsy

This study aims to evaluate the effects of a Core Stability Program on abdominal endurance and constipation severity in wheelchair-bound children with cerebral palsy. It seeks to determine whether targeted core strengthening exercises can improve muscular endurance of the abdominal region while also alleviating constipation symptoms, thereby enhancing overall functional health and quality of life in this population.

Inclusion Criteria: * Diagnosis of cerebral palsy - particularly spastic or hemiplegic types * Regardless the cause of CP * Age range typically 6-12 years old * A motor function level IV as per the Gross Motor Function Classification System * Grade 1 / 1+ (mild spasticity) according to Modified Ashworth Scale (MAS) * Non-ambulatory or inability to ambulate * CP children with constipation ; Fewer than 3 defecations per week, History of hard stools or painful defecation * Defecation frequency measured less than three times a week is considered constipation using Rome IV * Parental/guardian permission (informed consent) and child assent of a minor if the patient was able to assent (35). * The ability to understand and follow instructions Exclusion Criteria: * Had visual impairments, extreme spasticity, uncontrolled convulsions, any other neuromuscular diseases, ataxia-telangiectasia, spinocerebellar ataxia, and/or Joubert syndrome * Children who received botulinum toxin injection within the last six months, had fixed contractures or deformities of the spine or the extremities, and had previous surgeries of the spine or the lower extremities within one year or visual, auditary or respiratory disorders * Children with any other systemic co morbidities, physical deformity in GIT, intellectual disability and recent traumatic brain injury * Participation in other intensive physical therapy programs simultaneously * Severe musculoskeletal deformities that limit participation in the training * Children with congenital anatomic abnormalities of the urogenital area, including Hirschsprung's disease, spina bifida, anorectal malformations, urethral strictures, down syndrome or hypothyroidism, gastrointestinal bleeding, intestinal perforation, ileus obstruction, inflammatory bowel disease, toxic megacolon, metal implants or pacemakers in the abdominal area, open wounds in the abdominal and thoracic region, history of surgery on the stomach, malignancy .