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Relationship Between Postural Asymmetry, Balance, and Pain in Children With Spastic Cerebral Palsy
Zahra Shekari1, Razieh Sadeghian Afarani2, Saeid Fatorehchy3
1Masters Degree, Faculty of Rehabilitation Sciences, Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Insights
Postural asymmetry in children with cerebral palsy (CP) significantly worsens balance and increases pain. Interventions targeting postural issues can improve pain and balance in CP management.
Area of Science:
- Pediatric rehabilitation
- Movement science
- Clinical neurology
Background:
- Cerebral palsy (CP) presents primary symptoms like spasm and weakness.
- These primary symptoms can lead to secondary musculoskeletal issues.
- Understanding secondary symptoms is crucial for effective CP management.
Purpose of the Study:
- To investigate the relationship between postural asymmetry, balance, pain, and gross motor function in children with CP.
- To determine the impact of postural asymmetry on key functional outcomes in pediatric CP.
- To provide insights for targeted interventions in CP care.
Main Methods:
- 56 children (8-12 years) with GMFCS levels I-III participated.
- Evaluated balance using The Pediatric Balance Scale.
- Assessed pain with the Wong-Baker Faces Scale and posture with the Posture and Postural Ability Scale.
- Statistical analyses included Kruskal-Wallis, Tukey, and ANOVA.
Main Results:
- Significant correlation found between balance and postural asymmetry (P < 0.001).
- Postural asymmetry significantly correlated with pain intensity (P < 0.001) and gross motor function (P = 0.002).
- No significant relationship was found between pain and gross motor function (P = 0.072).
Conclusions:
- Postural asymmetry negatively impacts balance in children with CP.
- Addressing postural asymmetry is linked to improved pain management and balance.
- This highlights the importance of postural assessment and intervention in pediatric CP.
Background:
Primary symptoms of cerebral palsy (CP), such as spasm and weakness, can lead to secondary musculoskeletal problems. Exploring the interplay and impact of secondary symptoms is essential in CP management.
Methods:
A total of 56 children (32 males and 24 females) aged eight to 12 years in level I to III of Gross Motor Function Classification System (GMFCS) completed The Pediatric Balance Scale and Wong-Baker Faces Scale and the Posture and Postural Ability Scale. Relationships between the three groups were examined using the Kruskal-Wallis test, Tukey test, gamma coefficient, De Somers D, phi coefficient, Cramér V, and one-way analysis of variance.
Results:
There was a significant correlation between balance and postural asymmetry (P < 0.001), and no significant difference in balance was there between the severe and moderate asymmetry groups (P = 0.759) and between the mild asymmetry and no asymmetry groups (P = 0.374). Furthermore, there was a significant relationship between postural asymmetry and each of the variables of pain (P < 0.001) and gross motor function (P = 0.002). Although a meaningful correlation was identified between balance and gross motor function (P < 0.001), the relationship between postural asymmetry and balance in GMFCS levels was not found (P = 0.052, P = 0.052, P = 0.233). Conversely, no significant relationship was detected between pain and gross motor function (P = 0.072).
Significance:
Postural asymmetry negatively impacts balance and correlates with pain intensity. Addressing postural problems can contribute to pain management and improved balance.
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