Functional reaching discloses perceptive impairment in diplegic children with cerebral palsy

Ferrari, Adriano; Tersi, Luca; Ferrari, Alberto; Sghedoni, Alice; Chiari, Lorenzo

doi:10.1016/j.gaitpost.2010.05.010

Cited by 24 publications

(25 citation statements)

References 25 publications

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“…One indication may be seen in less movement between head and trunk in the CP2 group, possibly due to experienced spatial insecurity. Even if examined in sitting, this appearance may be associated and understood based on reported decreased ability to quickly produce anticipatory postural adjustments in children with perceptual disorder (Ferrari et al, 2010). On the other hand, similar rotational movements in head and trunk in CP3 as in the other groups may reflect that the walker offered a frame for facilitating special perception.…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Ferrari et al (2014), interrater reliability was moderate for startle position in upper limbs, and fair for posture freezing, nevertheless we consider the signs useful to characterize postural responses in children with disturbances in movement and posture as mentioned in the definition of CP. The impact of perceptual disorder in children with CP has also been investigated during a functional reach and touch experiment from a sitting posture (Ferrari, Tersi, Ferrari, Sghedoni, & Chiari, 2010). Their results showed that children diagnosed with CP and perceptual disorder had major difficulty in accomplishing the reaching tasks, and rarely recruited anticipatory postural adjustments, each of which was characterized by small amplitude and inaccuracy in direction.…”

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confidence: 99%

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Head and Trunk Movements During Turning Gait in Children with Cerebral Palsy

Bartonek

Lidbeck

Hellgren

et al. 2018

Journal of Motor Behavior

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Thirty children with cerebral palsy (CP) and 22 typical developing (TD) were tested with 3D-gait analysis. At turning, trunk rotation was larger in CP2 (GMFCS II) than in TD and CP1 (GMFCS I), and head flexion was larger in CP3 (GMFCS III) than TD. Maximum head and trunk flexion values during the entire trial were larger in CP3 than in the other groups, and trunk flexion was larger in CP2 than in TD. Trial time increased with GMFCS-level. Less trunk rotation than TD and CP1 reflects spatial insecurity in CP2, which in CP3 is compensated by the walker. The flexed head and trunk in CP3 and trunk in CP2 may reflect deficits in proprioception and sensation requiring visual control of the lower limbs.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Head and Trunk Movements During Turning Gait in Children with Cerebral Palsy

Bartonek

Lidbeck

Hellgren

et al. 2018

Journal of Motor Behavior

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“…However, it has been reported that proprioceptive information processing is altered in individuals with CP (Riquelme and Montoya 2010). In addition, a recent study has revealed that individuals with spastic diplegia who have perceptive impairment exhibit a greater deficit in APAs associated with functional reaching while sitting than those without perceptive impairment (Ferrari et al 2010). Therefore, in individuals with spastic diplegia, the CNS may be unable to adequately scale APAs to fit task conditions because of proprioceptive deficits and/or poor motor experience attributable to motor disabilities.…”

Section: Discussionmentioning

confidence: 99%

Deficits in task-specific modulation of anticipatory postural adjustments in individuals with spastic diplegic cerebral palsy

Tomita

Fukaya

Ueda

et al. 2011

Journal of Neurophysiology

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We examined whether individuals with spastic diplegic cerebral palsy (SDCP) have the ability to utilize lower leg muscles in anticipatory postural adjustments (APAs) associated with voluntary arm movement while standing, as well as the ability to modulate APAs with changes in the degree of postural perturbation caused by arm movement. Seven individuals with spastic diplegia (SDCP group, 12-22 yr of age) and seven age- and sex-matched individuals without disability (control group) participated in this study. Participants flexed both shoulders and lifted a load under two different load conditions, during which electromyographic activities of focal and postural muscles were recorded. Although the timing of anticipatory activation of the erector spinae and medial hamstring (MH) muscles was similar in the two participant groups, that of the gastrocnemius (GcM) muscle was significantly later in the SDCP group than in the control group. An increase in anticipatory postural muscle activity with an increase in load was observed in MH and GcM in the control group but not in GcM in the SDCP group. The degree of modulation in MH was significantly smaller in the SDCP group than in the control group. An additional experiment confirmed that these differences in APAs between the two participant groups were unlikely to be attributable to their differences in initial standing posture before load lift. The present findings suggest that lower leg muscles play a minor role in APAs in individuals with spastic diplegia. In addition, it is likely that these individuals have difficulty modulating anticipatory postural muscle activity with changes in the degree of postural perturbation.

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“…Impairments in the perceptual system have been found to be associated with inefficient postural responses in children with bilateral CP in a study in which stability limits while sitting were provoked [27]. In another study, freezing of posture with a blocked rigid body position occurring during balance-provoking activities, was deemed attributable to a perceptual impairment in children with bilateral CP [18].…”

Section: Discussionmentioning

confidence: 99%

The role of visual stimuli on standing posture in children with bilateral cerebral palsy

et al. 2016

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BackgroundIn children with bilateral cerebral palsy (CP) maintaining a standing position can be difficult. The fundamental motor task of standing independently is achieved by an interaction between the visual, somatosensory, and vestibular systems. In CP, the motor disorders are commonly accompanied by sensory and perceptual disturbances. Our aims were to examine the influence of visual stimuli on standing posture in relation to standing ability.MethodsThree dimensional motion analysis with surface electromyography was recorded to describe body position, body movement, and muscle activity during three standing tasks: in a self-selected position, while blindfolded, and during an attention-demanding task. Participants were twenty-seven typically-developing (TD) children and 36 children with bilateral CP, of which 17 required support for standing (CP-SwS) and 19 stood without support (CP-SwoS).ResultsAll children with CP stood with a more flexed body position than the TD children, even more pronounced in the children in CP-SwS. While blindfolded, the CP-SwS group further flexed their hips and knees, and increased muscle activity in knee extensors. In contrast, the children in CP-SwoS maintained the same body position but increased calf muscle activity. During the attention-demanding task, the children in CP-SwoS stood with more still head and knee positions and with less muscle activity.ConclusionsVisual input was important for children with CP to maintain a standing position. Without visual input the children who required support dropped into a further crouched position. The somatosensory and vestibular systems alone could not provide enough information about the body position in space without visual cues as a reference frame. In the children who stood without support, an intensified visual stimulus enhanced the ability to maintain a quiet standing position. It may be that impairments in the sensory systems are major contributors to the difficulties to stand erect in children with CP.

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Functional reaching discloses perceptive impairment in diplegic children with cerebral palsy

Cited by 24 publications

References 25 publications

Head and Trunk Movements During Turning Gait in Children with Cerebral Palsy

Head and Trunk Movements During Turning Gait in Children with Cerebral Palsy

Deficits in task-specific modulation of anticipatory postural adjustments in individuals with spastic diplegic cerebral palsy

The role of visual stimuli on standing posture in children with bilateral cerebral palsy

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