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Motor strategies in standing up in children with hemiplegia
Leena Duvika Mewasingh1, Tayeb Sékhara, Karine Pelc
1Department of Neurology, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium.
Insights
Children with spastic hemiplegia exhibit altered movement patterns when standing up, showing less variability and more asymmetry. This finding aids understanding of motor control in cerebral palsy.
Area of Science:
- Neurology
- Developmental Pediatrics
- Movement Science
Background:
- Spastic hemiplegia, a form of cerebral palsy, impairs postural control and whole-body movement organization.
- Understanding the specific motor patterns in conditions like spastic hemiplegia is crucial for effective intervention.
Purpose of the Study:
- To investigate and characterize the segmental motor patterns during the transition from supine to standing in children with spastic hemiplegia.
- To compare movement patterns between children with spastic hemiplegia and unimpaired children.
Main Methods:
- Utilized a validated visual analysis scale for developmental research to assess movement patterns.
- Analyzed specific movement components in the upper limbs, trunk (axis), and lower limbs.
- Studied 15 children with spastic hemiplegic cerebral palsy and 14 typically developing children.
Main Results:
- Children with hemiplegia demonstrated movement patterns similar to controls but with significantly reduced interindividual variability.
- A notable preponderance of asymmetric movement patterns was observed in the hemiplegic group.
- A novel, stereotyped lower limb pattern was identified in two children with spastic hemiplegia.
Conclusions:
- The observed movement patterns in spastic hemiplegia align with the referent body image theory.
- The visual analysis approach systematically characterizes motor repertoire limitations in movement disorders.
- Findings may inform management strategies focusing on variability and symmetry, and serve as a follow-up tool.
Abstract:
In spastic hemiplegia, the organization of whole body movements is impaired by deficient postural control. We studied segmental motor patterns involved in standing up from supine position in 15 children with spastic hemiplegic cerebral palsy and 14 unimpaired children using a visual analysis scale previously validated for developmental research. This approach examines specific movement patterns in upper limbs, axis, and lower limbs. We found that children with hemiplegia use movement patterns described in normal children but with reduced interindividual variability and a significant preponderance of asymmetric patterns. One previously undescribed stereotyped lower limb pattern was observed in two children with spastic hemiplegia. Emergence of these patterns is consistent with the referent body image theory. This approach can systematically characterize the limited repertoire of movement in patients with disorders of movement and posture and therefore contribute to a better understanding of motor control. The approach may guide management proposals with particular reference to variability and symmetry and might be used as a follow-up tool.
