Influence of gait analysis on decision-marketing for lower extremity surgery

Effect of dynamic sitting balance training on posture and function in children with spastic diplegic cerebral palsy

HJ CHANG MD A, J H HWANG MD PHD A, H S KIM MD PHD, D S PARK
PT MS B, T KWON PHD C

  1. 1. Department of Physical Medicine and Rehabilitation, Samsung Medical Center;
  2. 2. Center for Clinical Medicine, Sungkyunkwan University School of Medicine;
  3. 3. Division of Bionics and Bioinformatics, Chonbuk National University, Korea

Objective: The aim of the study was to investigate differences in the dynamic postural control in unstable sitting positions in children with and without spastic diplegic cerebral palsy (CP) and to investigate whether the dynamic sitting postural control training in children with CP could improve balance and functional performance.

Study Design: Case-control study with matched normative comparison population.

Study Particpants: Fifteen children with spastic diplegic CP who could sit independently and 15 age-matched typically developing children were included.

Materials/Methods: The evaluation and training system for seated postural control consisted of unstable platform, force plate frame, safety harness, monitor, and computer. Force plate on unstable platform measured the centre of pressure (COP) of the participant. COP sway (the time to maintain COP on circle at centre and the distance away from central location), COP maintaining time (the time to maintain COP on desired target), and COP moving time (the time to move COP to reach desired target location away from central location) were recorded in the typically developing children group and the CP group. Children in the CP group had the 6-week training phase which consisted of 30-minute maintaining training (to move and maintain COP on random target) and sine curve trace training (to stay in circle following sine path) two or three times per week. Gross Motor Function Measure (GMFM) and the Functional Independence Measure (WeeFIM) were evaluated pre- and posttraining in the CP group.

Results: In COP sway, the distance away from central location was significantly increased and time maintaining on circle at center was significantly increased in the CP group (p<0.05). The children with CP showed significantly increased maintaining time and significantly decreased moving time on all direction. In the COP sway, time maintaining on circle at center was significantly increased post-training. The COP moving times on all directions except posterior were improved significantly after training phase (p<0.05). But, the COP maintaining time on all directions showed no significant change after training phase. GMFM and WeeFIM score show no significant improvement after training phase.

Conclusions: Children with spastic diplegic CP performed ssignificantly worse in sitting posture control compared with typically developing1 particpants of similar chronological age. Dynamic training for the postural control in unstable sitting positions improved sitting balance without showing any functional gain. Further studies are needed to explore long-term training effect with large sample size, mechanism of training-induced improvements, and change of muscle activity.

 
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