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Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children
Stella F Donker1, Annick Ledebt, Melvyn Roerdink
1Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands. s.f.donker@uu.nl
Insights
Children with cerebral palsy (CP) exhibit greater and more regular postural sway than typically developing (TD) children. Visual feedback improved sway regularity in TD children, suggesting potential therapeutic benefits for CP.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatrics
Background:
- Centre-of-pressure (COP) analysis is advancing for understanding postural control.
- Cerebral palsy (CP) affects motor function, including balance.
- Postural sway characteristics in children with CP require further investigation.
Purpose of the Study:
- To compare COP trajectory structure between children with CP and typically developing (TD) children.
- To investigate the effects of eyes open (EO), eyes closed (EC), and visual feedback (FB) on postural sway.
- To test hypotheses regarding sway amount, regularity, and the influence of external context.
Main Methods:
- COP trajectories were analyzed in 9 children with CP and 9 TD children.
- Participants stood quietly under EO, EC, and FB conditions.
- Sway was quantified by amount and regularity.
Main Results:
- Children with CP showed a trend towards larger and more regular sway than TD children.
- Visual feedback generally decreased sway regularity compared to EO and EC conditions.
- The effect of visual feedback on sway regularity was less pronounced in the CP group.
Conclusions:
- Children with CP may exhibit altered postural control characterized by increased and more regular sway.
- External functional contexts, like visual feedback, can modulate postural sway.
- Therapeutic strategies for CP could leverage postural tasks with external functional contexts.
Abstract:
Following recent advances in the analysis of centre-of-pressure (COP) recordings, we examined the structure of COP trajectories in ten children (nine in the analyses) with cerebral palsy (CP) and nine typically developing (TD) children while standing quietly with eyes open (EO) and eyes closed (EC) and with concurrent visual COP feedback (FB). In particular, we quantified COP trajectories in terms of both the amount and regularity of sway. We hypothesised that: (1) compared to TD children, CP children exhibit a greater amount of sway and more regular sway and (2) concurrent visual feedback (creating an external functional context for postural control, inducing a more external focus of attention) decreases both the amount of sway and sway regularity in TD and CP children alike, while closing the eyes has opposite effects. The data were largely in agreement with both hypotheses. Compared to TD children, the amount of sway tended to be larger in CP children, while sway was more regular. Furthermore, the presence of concurrent visual feedback resulted in less regular sway compared to the EO and EC conditions. This effect was less pronounced in the CP group where posturograms were most regular in the EO condition rather than in the EC condition, as in the control group. Nonetheless, we concluded that CP children might benefit from therapies involving postural tasks with an external functional context for postural control.
