Postural orientation and standing postural alignment in ambulant children with bilateral cerebral palsy

Area of Science:

• Biomedical Engineering
• Pediatric Physical Therapy
• Neurology

Background:

• Children with cerebral palsy often have impaired central postural control, affecting standing alignment.
• This study investigates body alignment in ambulatory children with bilateral cerebral palsy during quiet standing.

Purpose of the Study:

• To describe and compare the standing body alignment of ambulatory children with bilateral cerebral palsy to typically developing children.
• To identify distinct sagittal postural profiles in children with bilateral cerebral palsy.

Main Methods:

• Surface topography examination using Moiré topography was performed on 58 children with bilateral cerebral palsy and 45 typically developing children (aged 7-13 years).
• Sagittal postural profiles were classified using a data reduction technique, extracting eight key variables.
• Cluster analysis was used to group participants based on their postural profiles.

Main Results:

• Eight grouping variables included trunk inclination, pelvic tilt, lordosis, kyphosis-lordosis difference, vertebral lateral curvature, shoulder inclination, and shoulder/pelvic rotation.
• Cluster analysis revealed four distinct groups: Cluster 1 (25%), Cluster 2 (9%), Cluster 3 (49%), and Cluster 4 (17%).
• Three primary postural patterns were identified in children with cerebral palsy: lordotic, swayback, and balanced.

Conclusions:

• Children with bilateral cerebral palsy demonstrate specific sagittal postural patterns during quiet standing.
• These patterns include lordotic (forward-leaning), swayback (backward-leaning), and balanced postures.
• Understanding these distinct postural profiles is crucial for targeted interventions in pediatric cerebral palsy.