Selective motor control correlates with gross motor ability, functional balance and gait performance in ambulant
Guojun Yun1, Meihuan Huang2, Jianguo Cao2
1Department of Pediatrics, Shanxi Medical University, Taiyuan, China; Department of Rehabilitation Medicine, Shenzhen Children's Hospital, Shenzhen, China.
Insights
Selective motor control (SMC) deficits in children with bilateral spastic cerebral palsy (CP) are linked to poorer motor skills, balance, and gait. Improving SMC through physical therapy can enhance functional ability in these children.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Selective motor control (SMC) is crucial for human movement.
- Impaired SMC due to brain damage often causes coordination, balance, and gait issues.
- Children with bilateral spastic cerebral palsy (CP) frequently experience difficulties with motor control.
Purpose of the Study:
- To investigate the association between impaired SMC and lower limb motor ability.
- To examine the relationship between SMC and functional balance in children with CP.
- To assess the link between SMC and gait performance in children with bilateral spastic CP.
Main Methods:
- Thirty-six children (aged 5-16) with bilateral spastic CP (GMFCS I-II) participated.
- Selective Control Assessment of the Lower Extremity (SCALE) measured SMC.
- Gross motor function (GMFM-88 D&E), balance (PBS, TUG), and gait (EVGS, 10MWT) were assessed.
Main Results:
- SCALE scores strongly correlated with gross motor function (GMFM-88 D&E) and balance (PBS).
- Significant correlations were found between SCALE and fast walking speed, TUG, and EVGS.
- Impaired SMC was strongly associated with poorer gross motor function, balance, and gait quality.
Conclusions:
- Deficits in lower extremity SMC are associated with reduced gross motor function and balance control in children with bilateral spastic CP.
- SMC impairments correlate with more severe gait deviations and slower walking speeds.
- Physical therapy interventions targeting SMC are recommended to improve functional outcomes in children with CP.
Background:
Selective motor control (SMC) is a fundamental component of typical human motion. As a result of brain damage, impaired SMC often leads to difficulties with coordination, balance, gait efficiency and symmetry.
Research Question:
What is the association between impaired SMC and lower limb motor ability, functional balance and gait performance in children with bilateral spastic cerebral palsy (CP)?
Methods:
Thirty-six children (aged 5-16 years) with spastic bilateral CP in Gross Motor Function Classification System (GMFCS) level I to II were included in this study. SMC was assessed using Selective Control Assessment of the Lower Extremity (SCALE). Gross motor function was assessed using Gross Motor Function Measure-88 items D and E dimension (GMFM-88 D&E). Functional balance was assessed using Pediatric Balance Scale (PBS) and Timed Up and Go Test (TUG). Gait quality was assessed using Edinburg Visual Gait Score (EVGS) and 10-Meter Walk Test (10MWT). Spearman's rank correlation analyses were used to determine the association between SMC and other factors.
Results:
Correlation analyses showed that SCALE was strongly positively correlated with GMFM-88 (D&E) (rs=0.756, p < 0.001), PBS (rs=0.769, p < 0.001), and height-normalized fast walking speed (rs=0.632, p < 0.001), and strongly negatively correlated with TUG (rs=-0.766, p < 0.001) and EVGS (rs=-0.893, p < 0.001).
Significance:
Lower extremity SMC deficits are associated with poor gross motor function and balance control, more severe overall gait deviations and decreased fast walking speed in children with bilateral spastic CP. Physical therapy should include interventions that promote selective motor control in order to improve overall functional ability.
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