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Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral
Meysam Roostaei1, Parvin Raji1, Khosro Khademi Kalantari2
1Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Upper extremity constraints significantly impact balance and mobility in children with hemiplegic cerebral palsy. These findings highlight the importance of considering arm function in therapy for improved postural control.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Science
Background:
- Hemiplegic cerebral palsy (CP) affects motor function, particularly in one upper extremity.
- Postural control is crucial for functional mobility and daily activities in children with CP.
- The role of upper extremities in dynamic postural control for this population is not fully understood.
Purpose of the Study:
- To investigate the impact of upper extremity (UE) constraints on functional and dynamic postural control.
- To compare these effects in children with hemiplegic CP versus typically developing children.
Main Methods:
- Evaluated 12 children with hemiplegic CP (GMFCS I-II) and 12 typically developing children (ages 5-12).
- Assessed functional mobility using the Timed Up and Go (TUG) test.
- Measured dynamic postural control using the Biodex Balance System under three UE conditions: free, simple constraint, and difficult constraint.
Main Results:
- UE constraints significantly affected overall stability, medial-lateral stability, anterior-posterior stability, and TUG scores in both groups.
- Children with hemiplegic CP demonstrated significant differences in stability indices and TUG scores compared to typically developing children.
- Statistical analysis revealed significant main effects for UE condition and group on key outcome measures.
Conclusions:
- The upper extremity plays a significant role in maintaining functional balance and postural stability.
- Therapeutic interventions for children with hemiplegic CP should incorporate strategies to address UE function.
- Considering UE involvement is essential for optimizing rehabilitation outcomes in pediatric hemiplegic CP.
Purpose:
To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy.
Materials And Methods:
Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I-II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water).
Results:
The UE condition had significant effects on Overall Stability Index (OSI) (F(2,44) = 24.899, p < .001), Medial-Lateral Stability Index (MLSI) (F(2,44) = 4.380, p = .018), Anterior-Posterior Stability Index (F(2,44) = 6.187, p = .004), and TUG scores (F(2,44) = 113.372, p < .001). Group was significant for OSI (F(1,22) = 7.906, p = .010), MLSI (F(1,22) = 13.113, p = .002), and TUG (F(1,22) = 36.282, p < .001).
Conclusions:
The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs.
