Postural balance in children with cerebral palsy

Abstract

Postural control deficits have been suggested to be a major component of gait disorders in cerebral palsy (CP). Standing balance was investigated in 23 ambulatory children and adolescents with spastic diplegic CP, ages 5 to 18 years, and compared with values of 92 children without disability, ages 5 to 18 years, while they stood on a force plate with eyes open or eyes closed. The measurements included center of pressure calculations of path length per second, average radial displacement, mean frequency of sway, and Brownian random motion measures of the short-term diffusion coefficient, and the long-term scaling exponent. In the majority of children with CP (14 of 23) all standing balance values were normal. However, approximately one-third of the children with CP (eight of 23) had abnormal values in at least two of the six center of pressure measures. Thus, mean values for path length, average radial displacement, and diffusion coefficient were higher for participants with CP compared with control individuals with eyes open and closed (p<0.05). Mean values for frequency of sway and the long-term scaling exponent were lower for participants with CP compared with control participants (p<0.05). Increased average radial displacement was the most common (nine of 23) postural control deficit. There was no increase in abnormal values with eyes closed compared with eyes open for participants with CP, indicating that most participants with CP had normal dependence on visual feedback to maintain balance. Identification of those children with impaired standing balance can delineate factors that contribute to the patient's gait disorder and help to guide treatment.

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial

“…Deficits in postural control constitute a major limitation to the motor development in children with cerebral palsy (CP) 7 . These children exhibit a number of limitations stemming from postural instability on the performance of static and dynamic tasks, such as sitting, standing and walking [7][8][9][10] .…”

“…These children exhibit a number of limitations stemming from postural instability on the performance of static and dynamic tasks, such as sitting, standing and walking [7][8][9][10] . The clinical condition of CP includes neuromuscular deficits, such as the loss of selective motor control and alterations in muscle tone, leading to an imbalance between agonist and antagonist muscles, compromised coordination, sensory alterations and weakness 11 .…”

Posturografia na análise do equilíbrio em crianças com paralisia cerebral: revisão de literatura

“…From the other analyzed studies, five of them used the force platform aiming to compare the balance variables between groups of children with CP and with TD 7,[14][15][16][17] . These articles also point to the lower postural control in groups with CP.…”

Side-Alternating Vibration Training for Balance and Ankle Muscle Strength in Untrained Women

“…20 Postural sway was quantified by peak-to-peak amplitude (CoPmax) and the standard deviation (CoPsd) of CoP oscillations along the A/P and M/L axes. To avoid the dynamic phase of the task reflecting the postural adjustments caused by the weight transfer 21 and to avoid any fatigue effect during the task, we discarded 2 seconds from the beginning and 2 seconds from the end of the analysis.…”