Efectiveness of Rib Cage Mobility Exercises
versus Conventional Physiotherapy
on Trunk Impairment in Children with
Neurodevelopmental Disorders: A
Randomized Trial
Disha Parmar, Sanjay Parmar,* Praveen S. Bagalkot, Sayali Joshi, &
Lakshita Shah
Department of Pediatrics, SDM University, Dharwad, India
*Address all correspondence to: Sanjay Parmar, Professor, PhD, PDF, SDM University, Dharwad, India;
Tel.: +0836-2462253; +0836-2477615; Fax: +(0836)2462253, E-mail: sanjaytparmar777@gmail.com
ABSTRACT: This study was conducted to determine the efectiveness of rib cage mobility exer-
cises and conventional physiotherapy on trunk impairment in children with neurodevelopmental
disorders. In this single-blind study, children were randomly allocated (n = 25) into two groups.
Group A (n = 15) participated in conventional Physiotherapy and Group B (n = 10) participated
in rib cage mobility exercises and conventional therapy. The intervention was conducted 5 days
a week for a period of 4 weeks. A signifcant diference was found on gross motor function mea-
sure 88 (GMFM-88) (P = 0.008), on segmental assessment of trunk control (SATCo) active (P
= 0.041) and SATCo reactive (P = 0.009) at week 4 for group A. Group B indicated signifcant
changes on GMFM-88 (P = 0.002), on SATCo active (P = 0.0040) on SATCo reactive (P = 0.024)
at week 4. Within-group showed a statistically signifcant diference, for the above-mentioned
components. The between-group analysis did not show a statistically signifcant diference. The
minimal clinically important diference was found to be probable for groups A and B. Interven-
tion targeting trunk control in the form of exercises are helpful in early age children. Rib cage
mobility exercises did not show signifcant change although may be studied in a larger sample
and older children.
KEY WORDS: chest wall exercises, segmental assessment of trunk control, gross motor func-
tion measure 88, rib cage mobility, neurodevelopmental disorders.
I. INTRODUCTION
Neurodevelopmental is a dynamic inter-relationship between genetic, brain, cognitive,
emotional, and behavioral processes across the developmental lifespan. Signifcant and
persistent disruption to this dynamic process through environmental and genetic risk can
lead to neuro-developmental disorder (NDD).
1
The diagnosis of NDD requires a fexible
approach to patient treatment.
2
NDD includes disorders like Cerebral Palsy, Rett syn-
drome, Down’s syndrome, Prader-Willi syndrome, etc. Prevalence of NDD in specifc
sites of India ranges from 2.9% to 18.7% in 2 to less than 6 years old children.
3
NDD
afects CNS function during the developmental period and the efect is seen in domains
of motor skills, cognition, behavior, and communication.
0896-2960/22/$35.00 © 2022 by Begell House, Inc. www.begellhouse.com 23
Critical Reviews™ in Physical and Rehabilitation Medicine, 34(4):23 –37 (2022)