A total of 54 children, aged between 6 and 12 years, diagnosed with hemiplegic cerebral palsy and not meeting the exclusion criteria, who registered at the outpatient clinics of the Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, between June 1, 2025 and March 1, 2026, were planned to be included in our thesis study, which was planned to be prospective, randomized and single-blind. Children and their parents will be informed verbally and in writing about the study's purpose, duration, and method of implementation, and their informed consent will be obtained. They will be asked to sign an "Informed Consent Form." Patient assessment and follow-up forms will be completed at pre- and post-treatment follow-ups. Patients who meet the inclusion criteria will be numbered according to their order of admission and then randomly assigned to either the intervention or control groups by a computer program.
In addition to a brochure showing the number of sets and repetitions to be given to the patients as a standard home exercise program, the Fun-Core video exercise program, designed as a child-friendly core stabilization exercise program to be performed 3 times a week, will be given to the intervention group (G1), and the exercises will be delivered to the participants through a website with special accounts.
The control group (G2) will receive a standard home exercise program in brochure format, showing the number of sets and repetitions. The exercise program will be performed at home three times a week for 8 weeks.
Children with hemiplegic cerebral palsy between the ages of 6 and 12
Children with Gross Motor Function Classification System (GMFCS) Levels 1, 2, and 3
Shoe sizes 30 and above
Cognitive impairments that prevent understanding and performing simple commands and tasks
Botulinum toxin injections into the upper and/or lower extremities within the last 6 months
History of lower extremity or lumbar surgery within the last year
Presence of uncontrolled severe epileptic seizures
Parallel
Exercise
Other interventionFun-Core Exercises will be narrated, prepared and recorded in video format, and then delivered in order to ensure children's development and motivation.
Exercise
Other interventionStandard home based exercise program
Modified Timed Up & Go Test
The mTUG test is a modified version of the Timed Up and Go (TUG) test for assessing functional mobility in children. It essentially measures how quickly an individual can perform the skills necessary for daily living activities-sitting, standing, walking, turning, and sitting down again. Unlike the standard TUG test, it includes instructions and environmental conditions tailored to the developmental level and cognitive capacity of children. In our study, the mTUG test will be administered to participants wearing shoes equipped with wearable sensors, and the test duration will be measured through the shoes.
Pediatric Balance Scale
It will be used to assess balance in children. It consists of 14 items, each item being scored from 0 to 4. The maximum score is 56. The higher the score, the better the child's balance. 1. sitting to standing 2. standing to sitting 3. transfers 4. standing unsupported 5. sitting unsupported 6. standing with eyes closed 7. standing with feet together 8. standing with one foot in front 9. standing on one foot 10. turning 360 degrees 11. turning to look behind 12. retrieving object from floor 13. placing alternate foot on stool 14. reaching forward with outstretched arm
Six Minute Walk Test
It is considered a measurement that assesses an individual's overall functional status. The test assesses the integrated response of respiratory, cardiovascular, skeletal, nervous, and muscular components. A 30-meter track will be used for the test. The total distance walked by the participant over 6 minutes will be recorded in meters. In our study, the 6-minute walk test will be administered to participants wearing shoes equipped with wearable sensors, and the test will be measured through the shoe.
Trunk Endurance Tests
Performance assessment is conducted by recording the maximum time the individual can maintain the test position. Before each test, the child is asked to maintain the test position for as long as possible. Each test will be repeated three times, and the average time will be recorded. To minimize the risk of injury or psychological distress, the tests will be explained in detail to the children beforehand, and their administration will be demonstrated. Two healthcare professionals will be present during each test to ensure the child maintains proper form and ensure safety. Back extension test: Biering-Sørensen position with trunk held horizontal, pelvis/legs strapped; ended at loss of position or 300s. Lateral torso test: Full side-bridge with straight body on elbow; stopped when posture broke or 300s. Flexor test: Sit-up at 50° support, arms crossed, feet secured; ended when back touched support or 300s.
Pediatric Reach Test
It is a measurement method that evaluates the dynamic component of balance. The test will be conducted by measuring the distance in centimeters that participants can reach forward, then to the right and left, without lifting their heels while standing upright. The procedures will be explained to participants once, and then they will be asked to perform the exercise three times. They will be expected to hold each position for at least 3 seconds. Measurements where participants lose their balance and lift their feet off the ground will be invalid. The distance reached will be measured in centimeters using a non-stretchable tape measure. The test consists of two sections: sitting and standing, with three items in each section (six items in total). The total score is calculated by measuring the distance in centimeters between the starting position (shoulder flexed 90° for forward reach and shoulder abducted 90° for side reach) and the maximum stable reach.
WeeFIM
The WeeFIM is used to measure functional independence in activities of daily living for children aged 6 months to 12 years. It consists of 18 items covering self-care, toilet control, mobility, locomotion, communication, and social development. A 7-level ordinal rating system ranging from 7 (complete independence) to 1 (total assistance), is used to score performance in each item. As with the FIM, the Wee- FIM consists of two dimensions: motor and cognitive. The WeeFIM is a reliable and valid tool for assessing the functional status of children with CP.
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