Performance of Static Standing Balance in Children With Spastic Diplegic Cerebral Palsy Under Altered Sensory Environments1

Abstract

Seven children with spastic diplegic cerebral palsy and 14 age- and gender-matched nondisabled children participated in the present study for an investigation and comparison of their static standing balance under altered sensory environments. The type of visual input (full, occluded, or sway referenced vision) and the type of somatosensory input (fixed or compliant foot support) were varied factorially to give six sensory environments. Each participant was tested barefooted for 30 s under all six conditions. A force platform collected the ground reaction force, from which standing balance was calculated as the sway area of the center of pressure. The results showed that when somatosensory information was reliable (fixed foot support), there was no significant difference in stance stability between the children with spastic diplegic cerebral palsy and their matched controls, and both types of children were equally affected by the type of visual input. However, when somatosensory information was unreliable (compliant foot support), the difference in stance stability between the children with spastic diplegic cerebral palsy and their matched controls was significantly greater when the visual input was deprived (occluded) or unreliable (sway referenced) than when it was reliable. These results suggest that the children with spastic diplegic cerebral palsy may have difficulties in resolving intersensory conflicts for maintenance of standing balance, or the demands of motor control in sensory conflict conditions outweigh the motor ability of children with spastic diplegic cerebral palsy.

Use of Sensory Information During Postural Control in Children With Cerebral Palsy: Systematic Review

“…Only four studies assessed specific types of motor impairment using homogenous samples Burnet et al, 1998;Cherng et al, 1999;Donker et al, 2008). Two studies assessed children with spastic diplegic CP (Burtner et al, 1998;Cherng et al, 1999), and two assessed children with spastic hemiplegic CP Donker et al, 2008).…”

“…Two studies assessed children with spastic diplegic CP (Burtner et al, 1998;Cherng et al, 1999), and two assessed children with spastic hemiplegic CP Donker et al, 2008). Brogren, Forssberg, and Hadders-Algra (2001) assessed children with spastic diplegic CP; however, the subjects comprised children with different levels of motor impairment.…”

Generalizability of center of pressure measures of quiet standing

“…It is a summary measure representing the movements of all of the body segments while an individual attempts to remain upright. COP has been used to investigate changes in postural control in a variety of healthy and special populations [2][3][4][5][6][7][8][9][10][11][12]. Although, measures of COP are commonly used for assessing balance, there is little standardization in data collection protocol and methods used to analyze fluctuations of the COP [2][3][4][5][6][7][8][9][10][11][12].…”

Characteristics of hand tremor and postural sway in patients with fetal-type Minamata disease

“…In this way, these objective tests with spectral analysis may be helpful in supplementing differential diagnosis between Minamata disease and other neuromotor disorders excluding cerebral palsy, provided that a patient has a pathological tremor or postural instability. Concerning cerebral palsy, the patient may have some problems such as mental retardation, epilepsy or sensory disturbance, other than motor impairment (Kulak et al, 2006), but neither physiological data on tremor frequency nor consistent patterns of postural sway have been seen in the literature (Cherng et al, 1999;Rose et al, 2002;Donker et al, 2008). In the occupational exposure limit setting, tremor is considered as a critical effect of mercury vapor (ATSDR, 1999;ACGIH, 2009), and its poisoning resembles Minamata disease in clinical features.…”