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Published on: August 30, 2016
Step-Initiation Deficits in Children with Faulty Posture Diagnosed with Neurodevelopmental Disorders during Infancy
Magdalena Stania1, Alina Sarat-Spek2, Teresa Blacha2
1Faculty of Physiotherapy, Department of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
Insights
Children with faulty posture and a history of neurodevelopmental disorders exhibit distinct step initiation patterns compared to healthy peers. These findings support incorporating functional movement exercises into physiotherapy for improved motor control.
Area of Science:
- Pediatric physiotherapy
- Developmental pediatrics
- Movement science
Background:
- Early detection of movement deficits is crucial for effective physiotherapy in children.
- Children with faulty posture and a history of neurodevelopmental disorders may present with altered step initiation.
- Understanding these differences can optimize therapeutic strategies.
Purpose of the Study:
- To compare step initiation in 5- and 6-year-old children with faulty posture (and a history of neurodevelopmental disorders) versus healthy children.
- To identify specific movement deficits during step initiation in the affected group.
- To inform physiotherapy interventions for children with postural defects.
Main Methods:
- A case-control study involving 19 children (5-6 years) with faulty posture and neurodevelopmental history, and 19 healthy controls.
- Step initiation was assessed using force platforms under various conditions (e.g., with/without obstacles, stepping up/down).
- Center of foot pressure (COP) displacements were analyzed in three phases: pre-initiation, transit, and post-completion.
Main Results:
- Children with faulty posture showed significantly higher sway range (raCOP) and velocity (vCOP) in the sagittal and frontal planes during step-up and step-down trials compared to controls.
- Specific parameters like P1vCOPML, P3vCOPAP, P3raCOPML, and P3vCOPML were significantly elevated in the faulty posture group.
- These findings indicate greater postural instability and altered movement control during step initiation in children with postural defects.
Conclusions:
- Functional movement exercises, such as stair-walking tasks, are well-justified components of physiotherapy for children with postural defects.
- The study highlights the importance of assessing step initiation dynamics in children with neurodevelopmental disorders and faulty posture.
- Results support tailored physiotherapy interventions focusing on improving postural control and movement patterns.
Background:
Early detection of movement deficits during step initiation will facilitate the selection of the optimal physiotherapy management strategy. The main aim of the study was to assess potential differences in step initiation between 5- and 6-year-old children with faulty posture who had been diagnosed with neurodevelopmental disorders during infancy and healthy children.
Methods:
The experimental group consisted of 19 children aged 5-6 years with faulty posture, who had been diagnosed with neurodevelopmental disorders during infancy and were given physiotherapy in the first year of their lives. The control group comprised 19 nursery school children aged 5-6 years with no postural defects, no history of postural control or movement deficits, and no physiotherapy interventions in the first year of their lives. Step initiation was performed on force platforms under various conditions, i.e., with and without an obstacle, stepping up onto a platform placed at a higher level, stepping down onto a platform placed on a lower level. The recording of center of foot pressure (COP) displacements was divided into three phases: phase 1 (P1)-quiet standing before step initiation, phase 2 (P2)-transit, phase 3 (P3)-quiet standing until measurement completion.
Results:
The Tukey post hoc test showed that the means of sway range (raCOP) and mean velocity (vCOP) in sagittal (AP) plane for phase 1 and vCOP in frontal (ML) plane for phase 3 registered in the step-up trial were significantly higher (p < 0.05) in children with faulty posture compared to children with typical development. P1vCOPML, P3vCOPAP, P3raCOPML, and P3vCOPMLof the step-down trial were also significantly higher in children with faulty posture (p < 0.05).
Conclusion:
Inclusion of functional movement exercises (stair-walking tasks) in physiotherapy interventions for children with postural defects seems well justified.The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12617001068358).
