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Effect of Segmental Trunk Support on Posture and Reaching in Children With Cerebral Palsy
Victor Santamaria1, Jaya Rachwani, Sandra Saavedra
1Human Physiology Department & Institute of Neuroscience (Drs Santamaria, Rachwani, and Woollacott), University of Oregon, Eugene, Oregon; Biobehavioral Sciences Department (Dr Santamaria), Teachers College, Columbia University, New York City, New York; Psychology Department (Dr Rachwani), New York University, New York City, New York; Department of Rehabilitation Sciences (Dr Saavedra), University of Hartford, Connecticut.
Purpose:
To test the effects of segmental trunk support on seated postural and reaching control in children with cerebral palsy.
Methods:
Seventeen children (age range 2-15 y, Gross Motor Function Classification System levels III-V) were classified with the Segmental Assessment of Trunk Control into mild (complete trunk control/lower lumbar deficits), moderate (thoracic/upper lumbar deficits), and severe (cervical/upper thoracic deficits). Postural and arm kinematics were measured while reaching with trunk support at axillae, mid-ribs, or pelvis.
Results:
Children in the mild group did not display changes in posture or reaching across conditions. The moderately involved group showed decrements in postural and reaching performance with pelvic compared with higher supports (P < .01). Children in the severe group were unable to maintain posture with pelvic support and showed postural deficiencies with mid-ribs compared with axillae support (P < .01).
Conclusions:
Children with cerebral palsy and trunk dysfunction demonstrate improved motor performance when the external assistance matches their intrinsic level of trunk control.
