Impact of Serial Casting on Autonomic Nervous System Responses during Virtual Reality Tasks in Children with Cerebral
Marisa de Paula Paro1,2,3, Raísa Marques de Sousa1,2,3, Juliana Perez Martinez2
1Graduate Program in Medicine (Cardiology), Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 03828-000, Brazil.
Insights
Serial casting in children with cerebral palsy (CP) increases sympathetic activity at rest but reduces it during tasks. This intervention alters autonomic nervous system (ANS) responses without improving ANS behavior during physical activity.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) involves movement disorders affecting posture and mobility, often causing spasticity and joint contractures.
- Serial casting is a common intervention to enhance joint mobility and manage spasticity in children with CP.
- The impact of serial casting on the autonomic nervous system (ANS) in CP is not well understood.
Purpose of the Study:
- To investigate the effects of serial casting and ankle-foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task.
- To compare ANS responses between serial casting, AFOs, and barefoot conditions in children with CP.
Main Methods:
- Thirty children with CP were randomly assigned to three groups: serial casting, AFOs, or barefoot (n=10 per group).
- Heart rate variability (HRV) was measured during seated rest, a VR standing task, and a recovery phase to assess ANS activity.
- Autonomic nervous system (ANS) responses were analyzed across the three conditions.
Main Results:
- The serial casting group showed higher sympathetic activity during rest compared to AFOs and barefoot groups.
- However, the serial casting group exhibited a reduced sympathetic response during the VR task.
- A pronounced parasympathetic rebound was observed in the serial casting group during recovery, similar to the other groups.
Conclusions:
- Serial casting, while providing joint stability, modifies ANS response patterns in children with CP.
- It leads to increased sympathetic activation at rest but does not significantly improve ANS behavior during physical activity.
- Further research is needed to fully understand the implications of these ANS alterations.
Abstract:
Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on the autonomic nervous system (ANS) remain unclear. This study aimed to evaluate the effects of serial casting and ankle-foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task, comparing these interventions with a barefoot condition. Thirty children with CP were randomized into three groups (n = 10 per group): serial casting, AFOs, and barefoot. Heart rate variability (HRV) was used to assess ANS responses across three phases: seated rest, VR task, and recovery. The results showed that the serial casting group exhibited higher sympathetic activity during rest compared to the other groups, but had a reduced sympathetic response during the VR task. Additionally, the serial casting group displayed a more pronounced parasympathetic rebound during recovery, similar to the orthoses and barefoot groups. While serial casting provides essential joint stability, it alters ANS response patterns, leading to heightened sympathetic activation at rest, without providing significant improvements in ANS behavior during physical activity.
