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Published on: August 9, 2024
Postural adjustment of children with spastic diplegic cerebral palsy during seated hand reaching in different
Yun-Huei Ju1, Ing-Shiou Hwang, Rong-Ju Cherng
1Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.
Insights
Children with diplegic cerebral palsy (CP) exhibit less efficient postural adjustments during reaching tasks, particularly when reaching sideways. Their movement patterns are linked to overall postural control and hand movement quality.
Area of Science:
- Movement Science
- Neuroscience
- Rehabilitation Medicine
Background:
- Children with diplegic cerebral palsy (CP) often display impaired motor control and balance.
- Postural adjustments are crucial for stable reaching, but are often affected in children with CP.
Purpose of the Study:
- To investigate how reaching in different directions impacts postural adjustments in children with diplegic CP.
- To explore the relationship between hand reach performance, postural control, and postural adjustments in this population.
Main Methods:
- A cross-sectional study involving children with CP and typically developing (TD) children.
- Utilized force platforms to measure ground reaction force (GRF) and center of pressure (COP) during reaching tasks.
- Key outcome measures included peak COP velocity, COP sway ratio (SR), and GRF.
Main Results:
- Children with CP demonstrated greater peak COP velocity and a wider COP pattern (smaller SR) during medial-lateral reaches compared to TD children.
- Exaggerated postural adjustments and greater force modulation were observed in children with CP.
- A moderate correlation was found between SR and the Pediatric Reach Test score, and between chair SR and hand movement units.
Conclusions:
- Children with CP exhibit less efficient and more variable postural adjustment patterns, especially during medial-lateral reaches.
- Reaching medially or laterally poses greater postural challenges for children with CP due to trunk rotation.
- The observed postural adjustment patterns in children with CP are associated with their postural control abilities and the smoothness of their hand movements.
Objectives:
To examine the effect of reaching in different directions on postural adjustment in children with diplegic cerebral palsy (CP), and to examine the relationship between hand reach performance and postural adjustment, and between postural control ability and postural adjustment.
Design:
Cross-sectional study.
Setting:
A movement science laboratory at a medical university.
Participants:
Children with CP (n=12) and typically developing (TD) children (n=16).
Interventions:
Not applicable.
Main Outcome Measures:
Two force platforms were used to measure the ground reaction force (GRF) and center of pressure (COP) data. Absolute peak COP velocity, COP sway ratio (SR), and mean GRF in the anterior posterior direction during the acceleration and deceleration segments of a reaching task were the main outcome measures.
Results:
Children with CP showed a greater absolute peak COP velocity in the medial lateral direction, a smaller SR (wider COP pattern), and greater amplitude of force modulation (exaggerated postural adjustments) than TD children in lateral or medial reaches. There was a moderate correlation between SR and total Pediatric Reach Test score. The chair SR was also negatively correlated with the hand movement units.
Conclusions:
Children with CP showed wider, more crooked, and less efficient COP patterns than TD children, especially on medial or lateral reaches. Reaching medially or laterally involves trunk rotation, which produces more postural challenges than reaching anteriorly to children with CP. The patterns of postural adjustments in children with CP were correlated with their postural control ability and hand-reach smoothness.
