Ankle proprioception in children with cerebral palsy

Area of Science:

• Neuroscience
• Motor Control
• Pediatrics

Background:

• Ankle proprioception is crucial for balance and movement.
• Children with cerebral palsy (CP) often exhibit motor impairments, including potential deficits in proprioception.
• Currently, no standardized clinical method exists to evaluate ankle proprioception in children with CP.

Purpose of the Study:

• To compare ankle position sense between children with CP and typically developing (TD) children.
• To establish a reliable method for assessing ankle proprioception in pediatric populations.
• To identify potential proprioceptive impairments in children with CP.

Main Methods:

• A custom device was used to passively rotate the ankle in a psychophysical forced-choice paradigm.
• Participants (15 children with CP, 58 TD children, aged 6-17) identified the more plantarflexed ankle position over 25 trials.
• Psychometric functions were fitted to determine the just noticeable difference (JND) threshold and random error for ankle position sense.

Main Results:

• Median JND thresholds were significantly higher in the CP group (4.3°) compared to the TD group (3.0°), indicating poorer ankle position sense.
• Three children with CP demonstrated JND thresholds exceeding the 95th percentile of the TD group.
• No significant differences were found in the random error (uncertainty) of ankle position sense between the groups.

Conclusions:

• The developed method effectively assesses ankle proprioception and can identify impairments in children with CP relative to normative data.
• This approach provides valuable data on proprioceptive status, potentially augmenting the clinical assessment of motor impairment in CP.
• The findings highlight the presence of ankle position sense deficits in some children with CP, underscoring the need for targeted assessment and intervention.