title: The safety and feasibility of an intervention to improve balance dysfunction in ambulant adults with cerebral palsy: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To investigate the safety, feasibility and potential efficacy of balance training in adults with cerebral palsy.
  
  
  METHODS
  Phase 2, assessor-blinded randomized controlled trial.
  
  
  METHODS
  Outpatient rehabilitation facility.
  
  
  METHODS
  A total of 17 ambulatory adults with cerebral palsy.
  
  
  METHODS
  Participants were randomly allocated to an eight-week, once-weekly, small group programme of balance training, or seated attention control activity. Balance training was individually tailored using the Balance Evaluation Systems test.
  
  
  METHODS
  Primary focus was feasibility, addressed by recruitment, retention, adherence, and safety. Efficacy was primarily evaluated with the Ambulatory Self-Confidence Questionnaire and the Balance Evaluation Systems test, at intervention conclusion and Week 24. Secondary outcomes included gait speed, walking distance, falls efficacy, fatigue, quality of life, and global impression of change.
  
  
  RESULTS
  Interventions were safe and feasible with no major adverse events. Adherence was high. At eight and 24 weeks, there were negligible between-group differences in Balance Evaluation systems test total. At 24 weeks, there was a small, non-significant between-group difference in favour of the balance group with effect sizes of 0.14 for ambulatory self-confidence, 0.10 for falls efficacy, and 0.12 for fatigue. There were significant between-group differences for self-reported walking confidence and balance change, in favour of the balance group at Weeks 8 and 24 (p < 0.05).
  
  
  CONCLUSIONS
  A customised balance programme is feasible and safe for ambulant adults with cerebral palsy. Small effects from balance training in selected outcomes occurred. Study replication with at least 38 participants per group to confirm efficacy is warranted.
authors.affiliation: Department of Physiotherapy, Monash University, Victoria, Australia prue.morgan@monash.edu.
authors.forename: Prue
authors.initials: P
authors.lastname: Morgan
authors.affiliation: Clinical Research Centre for Movement Disorders & Gait, Monash Health, Victoria, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
authors.forename: Arve
authors.initials: A
authors.lastname: Opheim
authors.affiliation: Department of Physiotherapy, Monash University, Victoria, Australia Clinical Research Centre for Movement Disorders & Gait, Monash Health, Victoria, Australia.
authors.forename: Dina
authors.initials: D
authors.lastname: Pogrebnoy
authors.affiliation: Clinical Research Centre for Movement Disorders & Gait, Monash Health, Victoria, Australia.
authors.forename: Stella
authors.initials: S
authors.lastname: Kravtsov
authors.affiliation: Department of Physiotherapy, The University of Melbourne, Melbourne, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McGinley
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Balance; cerebral palsy; exercise; randomized controlled trial