Instrumentation and a Protocol for Quantification of Upper-Limb Movement of Children With and Without Cerebral Palsy in Two Sitting Positions

Abstract

Rehabilitation Engineering Department, Hugh MacMillan Rehabilitation Centre, 350 Rumsey Road&dquo; Toronto, Ontario, M4G 1 R8.The object of this paper is to present a preliminary report on an attempt to quantitatively analyze the effects of altered sitting positions on characteristics of an upperextremity reaching movement seen in children. A pilot study was conducted at the Hugh MacMillan Rehabilitation Centre, where the short-term effects of a horizontal (0°) and anteriorly-inclined (100) seat base on reaching skills of nondisabled children and children with spastic cerebral palsy were studied, using a tracking system that can accurately and precisely measure path length and average velocity of the hand as it moves toward a target in three-dimensional (3-D) space. Seven subjects, four with cerebral palsy and three nondisabled, participated in the study. Findings demonstrated that the disabled subject's hand movement toward a target was significantly slower than that of normal subjects, regardless of sitting position. A significant difference was also found between groups of subjects for path length in response to a 0° position, where the distance traversed in 3-D space was longer for disabled subjects. In comparing seat positions on movement parameters for each group separately, no significant results were found. However, the trends identified through individual subject data inspection are encouraging and reflect that the tracking system is a viable rehabilitation research tool for the objective measurement of qualitative aspects of upper-limb movements. Further research is required in which the system could be used to gather normative data from larger samples of nondisabled children. In addition, future studies involving larger subgroups of neurologically disabled children across a wider age range are needed. In these studies, the short-and long-term effects of various interventions on upperlimb movement can be monitored.

Best seating condition in children with spastic cerebral palsy: One type does not fit all

“…Our study indicated that FW-tilting with foot-support was associated with a higher average velocity of reaching in all children with CP. Two other studies (Hadders-Algra et al, 2007;Reid Sochaniwskyj & Milner, 1992) evaluated the effect of FW-tilting on reaching velocity. Reid et al (1992) was unable to demonstrate an effect of 10°FW-tilting with foot-support on reaching velocity in Presented are the estimated marginal means based on the results from the (generalized) mixed effects models.…”

“…To improve activities and participation of school-age children with CP often seating adaptations are used (Hadders-Algra & Carlberg, 2008;ICF-CY, WHO 2007;McNamara & Casey 2007;Stavness, 2006). From a theoretical perspective, the position of the pelvis is considered to be a crucial factor to achieve a seating position that is optimal for upper extremity function (Green and Nelham, 1991;McNamara & Casey 2007;Pope, 2002;Reid, Sochaniwskyj & Milner, 1992;Stavness, 2006). The idea is to achieve a seating position in which the line of gravity of the child's trunk and pelvis is close to the ischial tuberosities.…”

“…It is common practice to provide these children, just as children with Developmental Coordination Disorder, with adaptive seating, to enhance their functional performance in daily life activities (Case-Smith & Clifford O'Brien, 2015;Ryan, 2012). In ambulatory children with CP, i.e., children who are able to sit independently and who function at Gross Motor Function Classification System (GMFCS) levels I to III (Palisano, Rosenbaum, Bartlett, & Livingston, 2007), focus of research on adaptive seating is on the potential effect of seat inclination (McNamara & Casey, 2007;Reid et al, 1992;Sochaniwskyj et al, 1991;Stavness, 2006). This implies that the focus of research in these children differs from that in children with severe CP in whom focus is on adaptive seating systems (Angsupaisal et al, 2015;Chung et al, 2008;McNamara & Casey, 2007;Stavness, 2006).…”

“…Nevertheless, studies disagreed on the effect of forward (FW) tilting, due to the use of different methodology, outcome parameters, and differences in the nature of the CP of study participants. One point of variance was the seat angle which varied from 5° (Cherng, Lin, Ju, & Ho, 2009;McClenaghan, Thombs, & Milner, 1992), 10° ( Cherng et al, 2009;Reid et al, 1992;Sochaniwskyj et al, 1991), to 15° (Cherng et al, 2009;Hadders-Algra et al, 2007;McClenaghan et al, 1992;Reid, 1996;Sochaniwskyj et al, 1991;Tsai, Yu, Huang, & Cheng, 2014). The studies did not reveal one consistently best seating angle, both with respect to head stability and reaching activities.…”

Influência do mobiliário nas atividades lúdicas em escolares com paralisia cerebral

“…11,12 Outros autores verificaram, em seus estudos, que a inclinação do assento de 0 a 15 graus anterior, melhorou o controle postural e, fez com que as mãos das crianças ficassem livres para realizar atividades. [13][14][15] Certo estudo indicou que o uso da órtese abdutora e as inclinações do assento horizontal e inclinado anteriormente diminuem a atividade muscular dos membros inferiores e melhoram a função de membros superiores. 16 Vários estudos mostraram efeitos positivos na função de membros superiores, em uma inclinação de neutra a leve (10°) da cadeira como um todo.…”