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Gross motor patterns in children with cerebral palsy and spastic diplegia
K Yokochi1, A Hosoe, S Shimabukuro
1Department of Pediatric Neurology, Seirei-Mikatabara General Hospital, Shizuoka, Japan.
Insights
Children with spastic diplegia, a form of cerebral palsy, exhibit distinct motor patterns in rolling, sitting, and crawling. Impaired movement and trunk instability correlate with the severity of locomotive disability in these children.
Area of Science:
- Neurology
- Pediatrics
- Motor Control
Background:
- Cerebral palsy (CP) significantly impacts motor development in children.
- Spastic diplegia is the most common CP subtype, primarily affecting leg movement.
- Understanding specific motor patterns is crucial for targeted interventions.
Purpose of the Study:
- To motoscopically analyze rolling, sitting, and crawling patterns in children with spastic diplegia.
- To investigate the relationship between these motor patterns and locomotive disability severity.
Main Methods:
- Motoscopic analysis of rolling, sitting, and crawling in 72 children with spastic diplegia.
- Assessment of trunk rotation, elbow support, thigh adduction, knee flexion, reciprocal thigh movements, and trunk lateral bending.
- Categorization based on observed motor patterns and disability severity.
Main Results:
- Severely affected children struggled with trunk rotation and elbow support during rolling.
- A 'between-heel' sitting pattern with adducted thighs and flexed knees was common.
- Crawling showed insufficient reciprocal thigh movements and significant trunk lateral bending.
- Most impaired children exhibited weight-bearing on flexed thighs without reciprocal leg movement, progressing to elbow-supported creeping.
Conclusions:
- Specific motor impairments in rolling, sitting, and crawling are characteristic of spastic diplegia.
- The severity of these motor patterns directly correlates with the degree of locomotive disability.
- Findings highlight the need for tailored therapeutic strategies addressing these specific movement deficits.
Abstract:
Rolling, sitting, and crawling patterns were motoscopically analyzed in 72 children with cerebral palsy and spastic diplegia; the relation between these patterns and the severity of the locomotive disability was studied. In rolling, trunk rotation and elbow support were difficult for the most severely diplegic children. When sitting, most patients had a between-heel sitting pattern in which the thighs were adducted and the knees were flexed. When crawling, the reciprocal thigh movements were insufficient and accompanied by lateral bending of the trunk in many patients. In the more impaired patients, the thighs supported the weight in flexion and did not move reciprocally. Creeping on the elbows without reciprocal leg movements was demonstrated in the most severely affected children after 2 years of age.