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Optimizing the Educational Process for Students in Special Schools – Study on the Development of Static and Dynamic Balance through Activation and Toning of the Core Area in Physical Education Lessons

Abstract

The study assessed the impact of core activation and toning programs on the static and dynamic balance of students with special educational needs (SEN) in middle school physical education classes. We found that over a period of 6 weeks, with 2 lessons per week, these programs led to significant improvements in the students’ balance, regardless of the type of disability. Students with visual impairments and sedentary lifestyles showed the greatest progress.

Somatic and functional measurements were conducted on the 15 students with special needs, and 9 tests (Bass Test, Flamingo Test, Functional Reach Test, Unipodal Test with left eye closed, Unipodal Test with right eye closed, Unipodal Test with left eye open, Unipodal Test with right eye open, Y-Balance Test left, Y-Balance Test right) were administered to assess static and dynamic balance. After implementing the core activation and toning program, a correlation analysis between the two variables was conducted, followed by the calculation of the t-test for paired samples to assess if there were significant differences between the two sets of measurements and tests.

After 6 weeks of using core activation and toning exercises with a frequency of 2 lessons per week for students with special needs, we observed a favourable increase in both static and dynamic balance for six pairs of tests. The differences were statistically significant at a significance level of 0.05 out of the 9 tests conducted. Proprioceptive stimulation played a crucial role in these improvements in static and dynamic balance among those with various types of disabilities (intellectual, visual, and auditory).

We recommend incorporating core activation and toning programs into physical education for children with disabilities to enhance muscle tone and balance. However, the small sample size reminds us that data generalization should be done with caution, and we suggest conducting further studies with a larger number of participants and a longer training duration. This study emphasizes the importance of balance development among students with SEN and the potential benefits of a core-focused approach in middle school physical education.

Keywords

special education system, students’ development, static balance, development program, physical education

JEL Classification

I20, I21, I24

1. Introduction

To address the scientific education and integration/inclusion of children with disabilities, it is essential to recognize that educational practices should stimulate the authentic psychic potential of each child, regardless of their genetic, congenital, or educational differences. This approach is feasible even if children have different developmental premises, highlighted by the “educability coefficient”. In the development and implementation of corrective, compensatory, and formative educational methods for children with disabilities, it is crucial to consider Piaget’s theories and post-Piagetian theories regarding the staged development of intelligence, concerning the chronology of the development of certain psychic processes and the neuropsychological and psychosocial characteristics determined by the aetiology, type, degree, complexity, and dynamics of the disability. Through personalized educational programs and projects developed through the collaboration of a multidisciplinary team, the objective is to activate the authentic psychic potential of children with disabilities and accelerate their psychic development. The concept of equal opportunities in education and development for children with different disabilities is thus understood and implemented in the specialized or integrated/inclusive education system (Roșan, A., 2015, Psihopedagogie Specială. Modele de Evaluare Și Intervenție, Ed. Polirom, pp. 87-91). Education and the development of balance are interconnected and essential for the progress and overall well-being of students with special needs. Integrating balance exercises into educational programs can significantly contribute to improving the quality of life for these students.

The development of balance enhances the ability of students with special needs to participate in physical and recreational activities. Access to these activities not only contributes to physical development but also to social and emotional development. Improved balance allows students to engage more effectively in educational activities. They can navigate the school environment better, participate in classroom activities, and interact with other classmates. The development of balance contributes to increased autonomy and independence. Students with special needs who develop balance skills can become more independent in their mobility and in managing daily tasks. Poor balance can increase the risk of accidents and falls. Developing balance helps reduce this risk, contributing to the safety of students in the school environment.

By improving balance, students with special needs can be involved in various adapted sports and physical activities. This not only contributes to their physical well-being but also to the development of social skills and teamwork. For students with special needs, it is important that activities are adapted to their ability level and personalized to provide a positive experience. Physical education can significantly contribute to their overall development and play an essential role in improving their quality of life. Adapting and individualizing physical education programs are key to ensuring that all students, regardless of their needs, benefit from these experiences.

Success in balance development can contribute to improving the self-esteem and confidence of students. The ability to perform activities that they might initially find challenging can have a positive impact on their self-perception. The development of balance makes students more adaptable in diverse environments. They can better manage changes in terrain or environmental conditions, which can be important in an educational context. Being in balance means achieving precise alignment, and through practice, we can refine our control over our bodies, positions, and posture by acting on key elements, namely: stabilizing the pelvis, stabilizing the spine, and toning the abdomen, thus finding our equilibrium.

The core area, also known as the “power centre” of the body, plays a vital role in supporting the stability and efficiency of our daily movements. The Core encompasses much more than a well-defined set of abdominal muscles; it includes all the muscles that support the spine, pelvis, and hips, providing a solid foundation for our movements. A strong core not only improves posture and prevents back pain but also has a profound impact on athletic performance, mobility, and the quality of everyday life.

In this article, we will explore the importance of core training and the health benefits it brings. We will also examine the main techniques and exercises used to develop and strengthen this essential region of the body, providing our readers with a detailed insight into how core training can significantly contribute to improving the well-being of students with SEN. In conclusion, the development of static and dynamic balance plays a significant role in improving the quality of education for students with special needs. It is important for these students to benefit from adapted programs and strategies that support the development of balance skills in parallel with their overall educational objectives.

2. Literature Review

The impact of core stability exercises and treadmill training on the balance of children with Down syndrome aged 4 to 6 years (Alsakhawi & Elshafey, 2019; Liang & Tasnaina, 2023) highlights that these types of interventions can significantly improve functional balance and overall stability in children with this disability (Ghaeeni et al., 2015; Mirshahi et al., 2023; Ungurean et al., 2023). These interventions should be integrated into physical therapy programs to support development and well-being (Moisescu & Burlui, 2020; Silisteanu et al., 2021). Another study focusing on the importance of caring for the core muscles for overall health and functionality proposes an exercise program that combines two widely used techniques (stable and unstable surfaces). It reveals a connection between lower back pain and poor trunk muscle development (Castañeda Colorado & Patiño Villada, 2020; Kumar et al., 2023).

In the context of maintaining health and well-being in adults, the effectiveness of medical gymnastics programs for abdominal muscles is highlighted (Cabañas Armesilla & Chapinal Andrés, 2014). Higher scores in static and dynamic balance have been demonstrated in studies on female soccer players (Elena et al., 2020; Göktepe & Günay, 2019; Zulfiqar et al., 2022), taekwondo athletes (Diaz-Sarmiento & Vásquez, 2020), gymnasts, and volleyball players (Esteban García, 2016; Ioan-Sabin et al., 2022; Szabo, 2015). These findings underscore the importance of developing and training the core for achieving performance and maintaining health(Canli & Samar, 2022; Kasaai et al., 2023; G. D. Mocanu et al., 2021; G.-D. Mocanu, 2022).

Undoubtedly, balance plays a crucial role in our existence, and to achieve and maintain it optimally, it is essential to have adequate control over our posture and body position. Developing this control can be achieved through continuous practice that focuses on three fundamental elements: stabilizing the pelvis, maintaining the spine in the correct position, and strengthening the abdominal muscles. When we successfully harmonize and synchronize these aspects, we find balance in our body and, consequently, in our daily life.

In conducting the present study, we started from a series of premises based on scientific foundations, the validity of which we aim to confirm through the applicability of the activation and toning program of the core area in the physical education lesson for students with Special Educational Needs (SEN), with the objective of developing static and dynamic balance.

The first foundation relates to the fact that toning the core area improves the neuromuscular system, reduces body sway, and displaces the centre of gravity. Stability exercises for the core area tone the muscles around the trunk and pelvic region, aiding in stabilizing the body and head during limb movements. Exercises that stabilize the core area facilitate neuromuscular memory and are effective for subjects with weak postural control. Access to education is crucial for students with disabilities as it promotes social inclusion, providing equal opportunities, facilitating personal development, increasing awareness and empathy, respecting fundamental rights, and eliminating stereotypes. Numerous studies highlight other limiting factors, apart from health status, which are true obstacles in the education of individuals with special needs, as for example: harassment, exclusion, marginalization, inadequate infrastructure (Aluko & Mampane, 2022; Fantiro et al., 2024; Manzoor, 2023).

Another study based on the education of students with disabilities presents various activities, such as physical therapy sessions, muscle strengthening exercises, balance exercises, stretching, and sports activities, emphasizing the important role of these physical activities in developing teamwork, competitive, and social skills (Korkmaz & Serdar, 2023; Rizki et al., 2023). An interesting study (Pham Thi Hai et al., 2022) focusing on the characteristics of students with learning difficulties and the benefits of STEAM education for these students emphasizes the advantages of STEAM and how to apply this method in inclusive education for students with learning difficulties. The results of numerous research studies indicate efforts to integrate STEAM into universal design for learning, being a practical way to implement inclusive education for students with learning difficulties. Our research complements the educational inclusion effort by finding and testing toning and core development programs to maintain static and dynamic balance, ensuring the targeted students have the necessary health for development on all levels.

The educational system must respond to all the educational needs of students with special needs, helping them form a conducive bio-psycho-social development environment, with the ultimate goal being integration into the socio-professional market. The Physical Education, Sports, and Health curriculum is part of the core curriculum, and the Physical Education and Sports discipline, carried out in inclusive education centres and special schools for students with intellectual, severe, and/or associated disabilities, according to the framework plan, is allocated 1 hour in the primary cycle and 2 hours in the middle school cycle. The activity is based on applying/respecting the principle of adapting to age and individual characteristics, with a permanent reference to the psycho-physical potential of each child. This discipline covers the indispensable need for movement, relaxation, and entertainment and complements the harmonious physical and mental development of the individual. Physical education develops psychomotor skills that allow and ensure the successful and enjoyable participation of students in community sports activities (Programe școlare învățământ special 2021, 2021).

In physical education lessons, emphasis should be placed on forming strong and correct motivation for practicing physical exercises according to rules (breaks between repetitions, the role of hygiene conditions, natural toughening factors, recovery after effort, etc.) that lead to the multilateral development of students with special needs. A study in Brazil based on higher education census data from 2009 to 2019 examines internal policies, accessibility to infrastructure, and programs for students with disabilities, presenting the implementation of corrective, compensatory, and personalized educational programs and projects, developed through multidisciplinary teamwork, with the aim of activating the authentic psychological and motor potential of children with disabilities (Beltrão et al., 2023; Kumar et al., 2023).

In the United States, the importance of integrating disability culture into university diversity, equity, and inclusion initiatives for students with disabilities is emphasized. The study highlights that although the Americans with Disabilities Act of 1990 improved access to higher education for students with disabilities, they are still marginalized and drop out of university at a rate 17% higher than students without disabilities (Kulshan, 2023; Misirlioglu, 2018; Vandra, 2020). Physical education for students with special needs requires an adapted and individualized approach to ensure that these students benefit from the same opportunities and advantages as other students. Each student with special needs has different needs and abilities. Therefore, it is essential to conduct an individual assessment of each student to understand their level of physical fitness, assistance needs, and any existing restrictions.

Based on the assessment, a personalized physical education program can be created to take into account the capacities and needs of each student. This program should include adapted exercises and provide the necessary support to ensure the active participation of the student. Equipment and the environment in which physical activities take place should be adapted to meet the needs of students with special needs. For example, specially designed equipment can be used, or adjustments to the playing field can be made to facilitate access and participation.

Promoting inclusion is crucial in physical education for students with special needs. Teachers and peers should be educated about the needs of these students and provide support to facilitate their interaction and participation in group activities. Open and constant communication with parents is essential. They can provide valuable information about the specific needs of their children and collaborate with the school to develop an appropriate physical education plan. Physical education teachers should receive proper training regarding teaching methods adapted for students with special needs. This should include understanding various needs and abilities, as well as effective adaptation strategies. Continuous assessment of the progress of students with special needs in the physical education program is crucial. Based on the assessment results, the program can be adjusted to respond to changes in skills and needs. Overall, physical education for students with special needs should promote a holistic approach, adapting to the individual needs of.

3. Methodology

In pursuit of the three mentioned elements and following the initial somatoscopic assessment conducted on students with SEN at the beginning of the 2022-2023 school year to establish individualized physiotherapy programs, we observed a predominance of hypotonia in the paravertebral, abdominal, and gluteal muscles. Somatic and functional measurements were conducted on the 15 students with special needs, and 9 tests (Bass Test, Flamingo Test, Functional Reach Test, Unipodal Test with left eye closed, Unipodal Test with right eye closed, Unipodal Test with left eye open, Unipodal Test with right eye open, Y-Balance Test left, Y-Balance Test right) were administered to assess static and dynamic balance. After implementing the core activation and toning program, a correlation analysis between the two variables was conducted, followed by the calculation of the t-test for paired samples to assess if there were significant differences between the two sets of measurements and tests.

After 6 weeks of using core activation and toning exercises with a frequency of 2 lessons per week for students with special needs, we observed a favourable increase in both static and dynamic balance for six pairs of tests. The differences were statistically significant at a significance level of 0.05 out of the 9 tests conducted. For pairs 1, 2, 5, 6, 8, and 9, the differences were statistically significant (p-values less than 0.05), indicating significant changes between the initial and final measurements. For pair 3, the differences were statistically significant with a confidence level of 0.009. For pair 4, the differences were not statistically significant (p = 0.294).

This was an initial alarm signal that the core of the body was unstable, favouring uncoordinated and compensatory movements associated with balance disorders. The decision to apply the Pilates method in these cases provided further motivation for research in this direction. Based on these considerations, the working hypothesis was formulated, assuming that by activating and toning the core of the body in students with special educational needs, even over a short period of 6 weeks, with a frequency of 2 lessons per week, we would achieve progress in both static and dynamic balance.

3.1. Participants and Research Organization

The research was conducted at the “Emil Gârleanu” Special Vocational School and its branch, the “P.P. Neveanu” Special Vocational School in Galați, Romania. It included an intervention group of 15 subjects, consisting of 11 students with intellectual disabilities from the 8th-grade class at the “Emil Gârleanu” Special Vocational School in Galați, 3 students with visual impairments, and 1 student with a hearing impairment from the 8th-grade class at the “P.P. Neveanu” Special Vocational School in Galați. The average age of the participants was 15±6. Inclusion criteria included the ability to stand on two feet and walk independently, conscious participation, and cooperation in the work program. Exclusion criteria encompassed severe health problems, musculoskeletal or tendon injuries, serious neurological conditions, severe intellectual disabilities, the use of medications affecting balance, and information obtained from medical certificates.

Written informed consent and information were provided by legal representatives/parents to allow minors to participate in the study. The study followed the principles of the Declaration of Helsinki and adhered to ethical guidelines for research involving human subjects. The study was conducted throughout the 2022-2023 school year, over a period of 6 weeks, from week 22 to week 28, with a frequency of 2 lessons per week.

3.2. Stage – Evaluation of Global Body Posture and Applied Methodology

We assessed 11 students from the “Emil Gârleanu” Special Vocational School in Galați, 8 boys and 3 girls, all with mild to moderate intellectual disabilities, with IQ scores ranging from 47 to 69. These students demonstrated an optimal level of understanding and assimilation of information, allowing them to actively participate in the physical education training programs.

Following the assessment of static posture, the following findings were noted:

Moderate musculoskeletal imbalances were observed in 10 students, with one student displaying pronounced imbalances.
Slight deviations in the sagittal and frontal planes of the spine were observed in 8 students.
Minor deviations in the alignment of the scapulo-humeral region relative to the transverse axis were observed in 8 students.
A slight deviation of the pelvic girdle in the frontal plane was observed in 5 students and in the sagittal plane in 3 students.
2 students exhibited valgus knees, 4 had varus knees, and 3 students had bilateral flat feet.
The static postural disturbances ranged from moderate to moderate to severe but did not hinder the implementation of a movement program aimed at training the core region of the body. Furthermore, considering the identified musculoskeletal dysfunctions, the activation of deep trunk and pelvic musculature was indicated to facilitate posture improvement.

From the “P.P. Neveanu” Special Vocational School in Galați, we monitored 4 students (3 boys and 1 girl). One student had a hearing impairment, one had a visual impairment, one had total optic nerve atrophy with residual vision in the right eye and had undergone hydrocephalus surgery, and one had congenital glaucoma with buphthalmos in the right eye and retinopathy of prematurity in the left eye. Following somatoscopic evaluation for static posture, the following observations were made:

Moderate musculoskeletal imbalances were noted in 3 students, with one student displaying pronounced imbalances.
Spinal deviations in the frontal plane were observed in 1 student, and sagittal plane deviations were observed in 2 students, with 1 student showing deviations in both planes.
Pelvic deviation in the sagittal plane was observed in 3 students.
Three students had genu valgum, 2 had valgus knees, 3 students had bilateral flat feet.

To assess the somato-functional and physical development of the students in terms of strength, coordination, balance, and flexibility, a series of measurements, balance tests, and motor skill assessments were conducted. Anthropometric parameters, such as height, weight, and body mass index (BMI), were considered. Heart rate measurements were taken for the Ruffier Test to assess fitness levels. To determine thoracic elasticity, the difference between the maximum inspiratory and expiratory chest circumference was calculated. All these measurements were necessary to establish the individual level of effort capacity and identify deficiencies in the respiratory process. Proper breathing is fundamental for any physical program, positively influencing the outcomes. Faulty breathing is an initial signal that we cannot implement the program until the subject learns to breathe correctly and efficiently.

After the initial evaluation, the following observations were made:

Five students with intellectual disabilities had less elastic chest cavities.
Three students were unable to perform a forced expiration, indicating abdominal and intercostal muscle deficits.
The overall fitness level was generally low, with ratings ranging from 1 (good) to 4 (satisfactory) and 2 (unsatisfactory).

Following the final evaluation, the following changes were observed:

On average, the subjects grew by 2 cm in height due to puberty.
Body weight remained within optimal ranges on average.
Thoracic cage elasticity improved slightly but remained below the 6 cm threshold, indicating increased rigidity.
The capacity to adapt to physical effort significantly increased, reaching moderate fitness levels.

For subjects with hearing impairments, there were noticed the following:

Chest cage elasticity was reduced.
Fitness levels were unsatisfactory.

For subjects with visual impairments, there were detected the following:

Two of them had reduced chest cage elasticity and they were unable to perform a forced expiration.
Fitness levels were generally low, with ratings of 2 (moderate) and 1 (satisfactory).

Motor skill tests were conducted to assess initial parameters related to upper and lower body strength, abdominal strength, back strength, and spinal mobility, all necessary for assessing the core area. The following tests were administered: push-ups, squats, standing long jump, trunk extension from a prone position, trunk lift from a supine position, and seated trunk flexion. To evaluate the ability to maintain a stationary position, the following tests were performed: one-legged stance with eyes open and closed, Functional Reach Test, and Flamingo Test. To assess the ability to maintain balance during movement, the Bass Test was conducted, except for subjects with visual impairments due to the impossibility of performing the test, and the Y Balance Test.

3.3. Contributions Regarding the Development of the Work Program Adapted to the Students’ Disabilities for Core Activation and Toning

Through the core activation and toning program, we aimed to improve flexibility, strength, and body awareness through controlled and coordinated movements, ultimately enhancing both static and dynamic balance. The operational objectives set for the core activation and toning program were as follows:

O1 – To correctly and controllably perform lateral or intercostal breathing exercises during physical effort.

O2 – To focus on body alignment, maintaining the correct posture and stability during exercise execution.

O3 – To improve control over exercises.

O4 – To enhance precision by activating isolated muscles while integrating the muscles needed to create the movement.

O5 – To identify execution errors.

O6 – To demonstrate determination in completing the established program.

As for the organization of the exercises, we designed a core activation and toning program as a fundamental part of physical education lessons. Over the course of the 6 weeks, the program was divided into three phases: initial for weeks 1-2 with a duration of 15 minutes, moderate for weeks 3-4 with a duration of 20 minutes, and advanced for weeks 5-6 with a duration of 25 minutes. The increase in difficulty and intensity involved doubling the exercise dosage every two weeks. The types of exercises used in the program were methodically and gradually repeated, taking into account the students’ age, type of disability, prior physical fitness, and their level of understanding.

The same program was implemented for both groups, one with intellectual disabilities at the “Emil Gârleanu” Special Vocational School in Galați and the other with sensory impairments at the “P.P. Neveanu” Special Vocational School in Galați. The intensity of effort was adapted based on their fitness levels, with slow-paced movements and asynchronous tempo of 1/4, 2/4, depending on the individual motor potential of the subjects. The core activation and toning program aimed to mobilize the scapulo-humeral girdle, stabilize the scapulo-humeral and pelvic girdles, tone the paravertebral muscles, activate the entire core area, tone the glutes and abdominal muscles (rectus, transverse, and obliques), stretch the anterior trunk muscles, mobilize the spine, and thoracic cage.

Below is a small excerpt from the core activation and toning program, which is a fundamental part of the physical education lesson:

Duration: 6 weeks

Frequency: 2 lessons per week

Duration: Initial Phase (I.P.) = 15 minutes; Moderate Phase (M.P.) = 20 minutes; Advanced Phase (A.P.) = 25 minutes

Nr. Crt.	Exercise	Description	Methodical Instructions	Objectives	Repetitions
Nr. Crt.	Exercise	Description	Methodical Instructions	Objectives	I.P.	M.P.	A.P.
1		Support on palms and knees, T1: protraction of the scapulo-humeral belt, T2: retraction of the scapulo-humeral belt simultaneously with lateral elbow flexion.	Inhale during protraction and exhale during retraction simultaneously with abdominal contraction; chest approaches the ground, gaze forward.	Mobilization of the scapulo-humeral belt	11×10 repetitions	21×10 repetitions	32×10 repetitions
2		Lying Face Support, T1: Knee Flexion T2: Return to Initial Position	Prone support, T1: knee flexion, T2: return to initial position. Gaze forward at a 45⁰ angle to the ground, shoulders lowered, palms support below shoulder level, tense abdomen, neutral pelvis. Inhale during knee flexion, exhale during knee extension.	Stabilization of the scapulo-humeral and pelvic belts with core zone activation	1×10 repetitions	21×10 repetitions	32×10 repetitions
3		Support on palms and knees, T1: raising the right arm forward and upward; T2: lowering the right arm to the side; T3: lowering the right arm downward; T4: returning to the initial position; T5-8 same as with the opposite arm	Palms are supported below shoulder level, and knees are supported below hip level, gaze forward at a 45⁰ angle to the ground. Mobilization is done solely from the scapulo-humeral joint, and the pelvis is fixed.	Mobilization and stabilization of the scapulo-humeral belt with activation of the trunk muscles.	11×10 rrepetitions	22×10 rrepetitions	32×10 repetitions

Table 1. Segment from the program applied for the activation and toning of the core area.

Source: The researchers.

3.4. Evaluation of the benefits of implementing the proposed program

The study on the impact of core activation and toning programs on the static and dynamic balance of students with special educational needs (SEN) in middle school physical education classes has several important benefits and implications. Here are some of the key benefits:

Improvement in Balance: The core activation and toning programs led to significant improvements in both static and dynamic balance among students with special needs. This is crucial for their overall physical well-being and enhances their ability to engage in various physical and recreational activities.
Inclusivity in Physical Education: The study emphasizes the importance of adapting physical education programs to cater to the needs of students with disabilities. By incorporating core activation and toning exercises, the study suggests a more inclusive approach to physical education that benefits students with diverse abilities.
Tailored Educational Programs: The findings highlight the effectiveness of personalized educational programs for children with disabilities. By considering individual differences, the study recommends developing and implementing corrective, compensatory, and formative educational methods to activate the authentic potential of each child.
Positive Impact on Autonomy and Independence: Improved balance contributes to increased autonomy and independence for students with special needs. This means they can become more independent in their mobility and daily tasks, leading to a better quality of life.
Risk Reduction: Developing balance skills helps reduce the risk of accidents and falls for students with special needs. This is particularly important in the school environment where safety is a priority.
Social and Emotional Development: Access to physical and recreational activities not only contributes to physical development but also enhances social and emotional development. Improved balance allows students to participate more effectively in educational activities, interact with classmates, and navigate the school environment.
Positive Effects on Self-Esteem: Success in balance development can positively impact the self-esteem and confidence of students. Overcoming challenges and participating in activities they might find initially challenging can contribute to a positive self-perception.
Adaptation to Diverse Environments: The development of balance makes students more adaptable in diverse environments. They can better manage changes in terrain or environmental conditions, which is important in an educational context.
Core Training for Overall Well-being: The study emphasizes the importance of core training not only for balance improvement but also for overall well-being. A strong core has positive effects on posture, back pain prevention, athletic performance, mobility, and everyday life quality.
Recommendations for Future Research: The study recognizes the importance of a larger sample size and longer training duration for more comprehensive insights. This recommendation encourages further research to build on the findings and refine the understanding of the benefits of core activation and toning programs for students with special needs.

In summary, the study provides valuable insights into the positive effects of core activation and toning programs on the balance of students with special needs, contributing to the development of more inclusive and tailored physical education programs.

4. Results and discussions

Statistical analysis was conducted using the SPSS software (Statistical Package for the Social Sciences – Version 26). The confidence interval was set at 95% (P < 0.05). Since there were only 15 subjects with various deficiencies and no possibility of dividing them into homogeneous groups, we calculated the paired-samples t-test to assess whether there are significant differences between the two sets of measurements.

Paired Samples Test
		Paired Differences					t	df	Sig. (2-tailed)
		Mean	Std. Deviation	Std. Error Mean	95% Confidence Interval of the Difference
		Mean	Std. Deviation	Std. Error Mean	Lower	Upper
Pair 1	Chest Elasticity_I – Chest Elasticity_F	-1,333	1,952	,504	-2,414	-,252	-2,646	14	,019
Pair 2	Ruffier Test_I – Ruffier Test_F	-,093	3,950	1,020	-2,281	2,094	-,092	14	,928
Pair 3	Height_I – Height_F	-11,36867	43,96703	11,35224	-35,71680	12,97946	-1,001	14	,334
Pair 4	Weight_I – Weight_F	,600	3,439	,888	-1,305	2,505	,676	14	,510
Pair 5	IMC_I – IMC_F	,542	1,313	,339	-,185	1,269	1,598	14	,132

Table 2. Results of the Paired Samples Test for Somatic-Functional Parameters Measured Before and After the Applied Program

Analyzing the results of the five pairs presented in the table, we can conclude the following:

Pair 1 (Chest Elasticity_I – Chest Elasticity_F): The mean difference is -1.333, the standard deviation of differences is 1.952, and the standard error of the mean difference is 0.504. The t-test has a t-value of 14 with a p-value (significance) of 0.019. The p-value (0.019) is less than the common significance level of 0.05, suggesting a significant difference in chest elasticity between the initial and final moments.
Pair 2 (Ruffier Test_I – Ruffier Test_F): The mean difference is -0.093, the standard deviation of differences is 3.950, and the standard error of the mean difference is 1.020. The p-value (0.928) is well above the significance level of 0.05, indicating no significant difference in the Ruffier test between the initial and final moments.
Pair 3 (Height_I – Height_F): The p-value (0.334) is greater than the significance level of 0.05, suggesting no significant difference in height between the initial and final measurements.
Pair 4 (Weight_I – Weight_F): The results show that the mean difference is 0.600, the standard deviation of differences is 3.439. The p-value (0.510) is greater than the significance level of 0.05, indicating no significant difference in weight between the initial and final measurements.
Pair 5 (BMI_I – BMI_F): The mean difference is 0.542, the standard deviation of differences is 1.313. The p-value (0.132) is greater than the significance level of 0.05, suggesting no significant difference in BMI between the initial and final measurements.

In conclusion, from these results, we can say that there is a significant difference in chest elasticity between the initial and final moments, but there are no significant differences in the other measurements (Ruffier test, height, weight, and BMI).

Paired Samples Test
		Paired Differences					t	df	Sig. (2-tailed)
		Mean	Std. Deviation	Std. Error Mean	95% Confidence Interval of the Difference
		Mean	Std. Deviation	Std. Error Mean	Lower	Upper
Pair 1	Y_Balance_stg_I – Y_Balance_stg_F	-4,881	8,578	2,215	-9,632	-,131	-2,204	14	,045
Pair 2	Y_Balance_dr_I – Y_Balance_dr_F	-4,207	9,766	2,522	-9,615	1,201	-1,668	14	,117
Pair 3	Test_Bass_I – Test_bass_F	-10,250	11,307	3,264	-17,434	-3,066	3,140	11	,009
Pair 4	Flamingo_I – Flamingo_F	1,000	3,419	,914	-,974	2,974	1,094	13	,294
Pair 5	functional_reach_test_I – functional_reach_test_F	-3,533	4,926	1,272	-6,261	-,805	-2,778	14	,015
Pair 6	test_unipod_closed_eye_left_I – test_unipod_closed_eye_left_F- –	-4,367	7,215	1,863	-8,362	-,371	2,344	14	,034
Pair 7	test_unipod_closed_eye_right_I – test_unipod_closed_eye_right_F	-3,933	7,294	1,883	-7,973	,106	2,088	14	,056
Pair 8	test_unipod_open_eye_left_I – test_unipod_open_eye_left_F	-12,036	12,515	3,345	-19,262	-4,810	3,598	13	,003
Pair 9	test_unipod_open_eye_right_I – test_unipod_open_eye_right_F	-10,714	13,853	3,702	-18,713	-2,716	2,894	13	,013

Table 3. Results of the Paired Samples Test for Static and Dynamic Balance Parameters Measured Before and After the Applied Program

Based on the analysis and statistical interpretation of the results of the difference test between initial and final testing, divided into the nine pairs of measurements, we can draw the following conclusions:

Pair 1 (Y_Balance_left_I – Y_Balance_left_F): The significance value is 0.045, indicating a significant difference at a 95% confidence level.
Pair 3 (Bass Test_I – Bass Test_F): The significance value is 0.009, indicating a significant difference.
Pair 5 (Functional Reach Test_I – Functional Reach Test_F): The significance value is 0.015, indicating a significant difference.
Pair 6 (Single-Leg Balance with Eyes Closed – Left_I – Single-Leg Balance with Eyes Closed – Left_F): The significance value is 0.034, indicating a significant difference.
Pair 8 (Single-Leg Balance with Eyes Open – Left_I – Single-Leg Balance with Eyes Open – Left_F): The significance value is 0.003, indicating a significant difference.
Pair 9 (Single-Leg Balance with Eyes Open – Right_I – Single-Leg Balance with Eyes Open – Right_F): The significance value is 0.013, indicating a significant difference.

Therefore, for these six pairs, the differences are significant at a significance level of 0.05. For the other pairs, the differences are not significant.

5. Conclusions

The results and conclusions of the study provide valuable information to specialists in the field of inclusive education regarding the benefits of core activation and toning programs for students with disabilities, even when applied for short periods, such as 6 weeks. They can use this data to develop and adapt effective educational programs, contributing to the improvement of the quality of education for children with Special Educational Needs (SEN). The study offers physical education teachers a framework and specific strategies for implementing effective programs within their lessons. This can enhance teaching methods and contribute to the development of motor skills and self-esteem in students with special needs.

Parents and students with special needs can benefit from understanding the positive impact of core activation and toning programs on their static and dynamic balance. This information may encourage parents to support their children’s participation in such programs and stimulate students to develop their physical abilities and gain greater confidence in their capabilities. The study contributes to the existing scientific literature by providing empirical evidence regarding the effectiveness of core activation and toning programs for students with SEN. It can serve as a reference source for researchers seeking to delve deeper into this topic or develop further research in the field of adapted physical education.

In accordance with the research hypothesis, we have confirmed the following:

After 6 weeks of using core activation and toning exercises, with a frequency of 2 lessons per week, in students with Cerebral Palsy (CP), we achieved a favourable improvement in both static and dynamic balance. This improvement was observed regardless of the type of disability, attributed to increased muscle strength and trunk and pelvic stability.
We observed visible progress in subjects with visual impairments and sedentary lifestyles following the implementation of core activation and toning programs in the short term. This led to a significant increase in muscle tone, adaptation to effort, and improvement in both static and dynamic balance.
Proprioceptive stimulation, which was predominant in the core activation and toning programs, contributed to better scores in static and dynamic balance for the three categories of disabilities: intellectual, visual, and auditory.
We recommend including the core activation and toning program in physical education classes to improve muscle tone and balance in children with disabilities. Further long-term research is needed to determine if the observed short-term improvements are sustained over time.

The small sample size may limit the generalizability of the obtained data. For optimal generalization of results, future studies with a larger number of children with visual and auditory impairments and longer training durations are recommended.

An especially important aspect of this research was how we worked with the subjects. We consistently trained the subjects to actively engage them in the proposed activities. We adapted the activities based on their mental dispositions and the uneven motor potential within the working group. Through perseverance in developing muscle strength, improving flexibility, and controlling the respiratory process and body posture, we successfully achieved the goal of developing body stability in both static and dynamic conditions for students with CP. These results were highlighted in the final assessments, increasing the self-esteem and self-confidence of the students, motivating them to continue actively and consciously participating in physical education activities.

About the Authors

Carmen Pârvu

ORCID ID: 0000-0002-2910-9494

“Dunărea de Jos” University, Faculty of Physical Education and Sports, Galați, Romania

carmen.parvu@ugal.ro

Cătălina Mârșiu

ORCID ID: 0009-0009-3744-1030

The Special Vocational School “Emil Gârleanu”, Galați, Romania

marsiucatalina@gmail.com

Dan Alexandru Szabo

ORCID ID: 0000-0002-7326-212X

Department of Human Movement Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Romania

dan-alexandru.szabo@umfst.ro

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