PURPOSE: To determine if Pilates-based exercise classes could be feasible and effective in changing gait kinematics and balance in ambulant children with Cerebral Palsy (CP). MATERIALS AND METHODS: A single-blind multi-centre randomised controlled trial compared a four-week, twice-weekly Pilates-based exercise class to a usual exercise control, for ambulant children with CP. Clinical outcome measures were three-dimensional trunk and lower limb kinematics during walking on level ground, uneven ground and crossing an obstacle; and clinical balance measures. Feasibility outcomes were adherence and enjoyment. RESULTS: Forty-six children (29 male, mean age 10 years 8 months (range 7 to 17 years), 23 per group) participated. After the four-week intervention, there were no significant between-group differences in trunk or lower limb gait kinematics. Differences were detected in Berg Balance Scale (1.38 points, 95% CI 0.58 to 2.18) and Functional Walking Test (1.40 points, 95% CI 0.58 to 2.22), but they were less than the minimum clinically important difference and therefore clinically insignificant. Median class attendance was 5/8 classes. CONCLUSION: Pilates-based exercises did not change lower limb or trunk kinematics during walking in children with CP and had a clinically insignificant impact on balance. Lower than anticipated adherence prompts consideration of more flexible delivery of future interventions.

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