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Postural Control in Children with Diplegic Cerebral Palsy: The Association with Cervical Joint Position Sense Error

Sinem Asena Sel1, Merve Ünal1, İsmet Tümtürk1

  • 1Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya Bilim University, Antalya, Turkey.

Journal of Motor Behavior
|August 5, 2026
PubMed

Insights

Children with spastic diplegic cerebral palsy (CP) have impaired postural control linked to cervical joint position sense error (CJPSE). Addressing CJPSE in rehabilitation may improve motor function in CP.

Area of Science:

  • Neurology
  • Pediatrics
  • Rehabilitation Medicine

Background:

  • Spastic diplegic cerebral palsy (CP) significantly impacts motor function in children.
  • Postural control and joint position sense are crucial for motor development and function.
  • Cervical joint position sense error (CJPSE) has not been extensively studied in relation to postural control in pediatric CP populations.

Purpose of the Study:

  • To investigate the relationship between postural control and cervical joint position sense error (CJPSE) in children with spastic diplegic CP.
  • To determine if impaired CJPSE is associated with reduced postural control and gross motor function.
  • To explore the potential of CJPSE assessment in pediatric CP rehabilitation.

Main Methods:

  • A cross-sectional study involving 38 children with spastic diplegic CP (GMFCS levels I-III, ages 5-12).
  • Cervical joint position sense error (CJPSE) was measured using the Cervical Range of Motion (CROM) device.
  • Postural control was assessed using the Trunk Control Measurement Scale (TCMS), and gross motor function with the Gross Motor Function Measure-66 (GMFM-66).
  • Spearman's rank correlation test was used to analyze the relationships between variables.

Main Results:

  • Significant negative correlations were found between CJPSE and postural control in multiple cervical movement directions (flexion, extension, left rotation, lateral flexion).
  • A small positive correlation was observed for right rotation.
  • Strongest associations between CJPSE and postural control were noted in the dynamic sitting subscale of the TCMS.
  • Gross motor function (GMFM-66) showed an inverse association with CJPSE, particularly in the GMFM-C and GMFM-E dimensions.

Conclusions:

  • Impaired CJPSE is closely linked to deficits in postural control and gross motor performance in children with spastic diplegic CP.
  • These findings suggest that CJPSE is a relevant factor influencing functional abilities in this population.
  • Incorporating CJPSE evaluation into the rehabilitation strategies for children with CP may lead to improved functional outcomes.

Keywords:
cerebral palsycervical joint position sense errorpostural control

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