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Effects of sensory cues on dynamic trunk control in children with spastic diplegic cerebral palsy
Nalin Khumlee1,2, Duangporn Suriyaamarit1, Sujitra Boonyong1
1Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Pathumwan, Bangkok Thailand.
Insights
Combined visual and verbal cues significantly improved dynamic trunk control in children with spastic diplegic cerebral palsy and typically developing children. This approach is more effective than using visual or verbal cues alone.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Motor control
Background:
- Dynamic trunk control is crucial for functional mobility in children.
- Children with spastic diplegic cerebral palsy (SDCP) often exhibit impaired trunk control.
- Evidence on sensory cueing for trunk control in SDCP is limited.
Purpose of the Study:
- To investigate the immediate effects of visual, verbal, and combined visual and verbal cues on dynamic trunk control.
- To compare these effects in children with SDCP and typically developing (TD) children.
- To assess trunk control in a sitting position using objective measures.
Main Methods:
- Twenty children with SDCP and 20 TD children (aged 8-12 years) participated.
- Participants performed trunk leaning tasks (forward, backward, lateral) under four cueing conditions: none, visual, verbal, and combined.
- Dynamic trunk control was evaluated using center of force (CoF) trajectory and limit of stability (LOS).
Main Results:
- Verbal cues and combined visual and verbal cues enhanced CoF trajectories in multiple directions for both groups.
- Combined visual and verbal cues improved the limit of stability (LOS) in both TD children and children with SDCP.
- The findings indicate a significant impact of sensory cueing on trunk control.
Conclusions:
- Combined visual and verbal cues demonstrate superior effectiveness in enhancing dynamic trunk control compared to individual cue types.
- This multimodal sensory approach offers a promising strategy for improving sitting balance and trunk stability in children.
- The study provides robust evidence supporting the use of combined cues in pediatric rehabilitation for SDCP.
Background:
There is a lack of evidence whether the combined visual and verbal cues could improve dynamic trunk control in the sitting position in children with spastic diplegic cerebral palsy (SDCP).
Objective:
To investigate the immediate effects of visual, verbal, and combined visual and verbal cues on dynamic trunk control in the sitting position in children with and without SDCP. Methods:Twenty children with SDCP and 20 typically developing (TD) children aged eight to 12 years in sitting positions maneuvered their trunks to lean forward, backward, to the left, and to the right under conditions of no sensory cues, visual cues, verbal cues, and combined visual and verbal cues. Dynamic trunk control in the sitting position was assessed using the center of force (CoF) trajectory and limit of stability (LOS).
Results:
Verbal cues and combined visual and verbal cues could improve CoF trajectories in the forward, backward, and leftward directions in TD children and children with SDCP. Combined visual and verbal cues could improve the LOS in both groups.
Conclusion:
This study provides evidence that combined visual and verbal cues are more effective at enhancing dynamic trunk control than either visual or verbal cues alone in TD children and children with SDCP.
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