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Published on: August 30, 2016
Postural stability in children with hemiplegia estimated for three postural conditions: standing, sitting and
Andrzej Szopa1, Małgorzata Domagalska-Szopa2
1Department of Physiotherapy, School of Health Sciences, Medical University of Silesia in Katowice, Poland.
Insights
Children with cerebral palsy (CP) and hemiplegia show postural instability, especially those with an anti-gravitational postural pattern (AGPP). Early identification of AGPP in CP can improve therapy for weight-bearing asymmetry.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Postural control deficits are a significant challenge for children with cerebral palsy (CP).
- Understanding the impact of different types of postural asymmetry on stability is crucial for effective intervention.
- This study differentiates between postural control in hemiplegic CP and mild scoliosis.
Purpose of the Study:
- To compare postural stability in children with hemiplegia versus children with mild scoliosis.
- To investigate the influence of specific postural patterns (pro-gravitational and anti-gravitational) in hemiplegic CP on stability.
- To establish a reference for postural stability using children with mild scoliosis.
Main Methods:
- Posturography was used to assess 45 children with hemiplegia and 51 children with mild scoliosis.
- Evaluations included static load distribution and center of pressure (CoP) measurements in standing, sitting, and kneeling positions.
- Children with hemiplegia were categorized into pro-gravitational postural pattern (PGPP) and anti-gravitational postural pattern (AGPP) groups.
Main Results:
- Postural instability was confirmed in children with hemiplegia, particularly those with an AGPP.
- Children with AGPP exhibited significant weight distribution asymmetry and greater lateral-medial CoP displacements than children with scoliosis.
- The study found partial confirmation of increased postural instability in hemiplegic CP.
Conclusions:
- Distinguishing between PGPP and AGPP in children with hemiplegia is valuable for refining early therapeutic strategies.
- Targeted interventions for children with AGPP can help prevent the establishment of abnormal weight-bearing patterns.
- This research highlights the importance of specific postural pattern identification in CP management.
Abstract:
Postural control deficit is one of the most important problems in children with cerebral palsy (CP). The purpose of the presented study was to compare the effects of body posture asymmetry alone (i.e., in children with mild scoliosis) with the effects of body posture impairment (i.e., in children with hemiplegia) on postural stability. Forty-five outpatients with hemiplegia and 51 children with mild scoliosis were assessed using a posturography device. The examination comprised two parts: (1) analysis of the static load distribution; and (2) a posturographic test (CoP measurements) conducted in three postural conditions: standing, sitting and kneeling. Based on the asymmetry index of the unaffected/affected body sides while standing, the children with hemiplegia were divided into two different postural patterns: a pro-gravitational postural pattern (PGPP) and an anti-gravitational postural pattern (AGPP) (Domagalska-Szopa & Szopa (2013). BioMed Research International, 2013, 462094; (2014). Therapeutics and Clinical Risk Management, 10, 113). The group of children with mild scoliosis, considered as a standard for static body weight distribution, was used as the reference group. The results of present study only partially confirmed that children with hemiplegia have increased postural instability. Strong weight distribution asymmetry was found in children with an AGPP, which induced larger lateral-medial CoP displacements compared with children with scoliosis. In children with hemiplegia, distinguishing between their postural patterns may be useful to improve the guidelines for early therapy children with an AGPP before abnormal patterns of weight-bearing asymmetry are fully established.
