Effect of Seat Surface Inclination on Postural Control During Reaching in Preterm Children With Cerebral Palsy

Background and Purpose Because it is debatable whether seat surface inclination improves motor function in children with cerebral palsy (CP), the effect of seat surface tilting on postural control and quality of reaching was studied. Subjects The subjects were 58 children with CP aged 2 to 11 years (34 with unilateral spastic CP, 24 with bilateral spastic CP). Methods During the task of reaching movements, surface electromyographic and kinematic data were recorded for posture and reaching with the dominant arm in 3 sitting conditions: horizontal seat surface, seat surface tilted forward 15 degrees, and seat surface tilted backward 15 degrees. Results In the children with unilateral spastic CP, forward tilting improved postural efficiency and quality of reaching. In the children with bilateral spastic CP, both forward and backward tilting of the seat surface was associated with more postural instability and did not affect the quality of reaching. Discussion and Conclusion The results suggest that, in terms of postural control and quality of reaching, children with unilateral spastic CP benefit from a forward-tilted position and children with bilateral spastic CP benefit from a horizontal sitting position.

[1]  C. Von Hofsten Structuring of early reaching movements: a longitudinal study. , 1991, Journal of motor behavior.

[2]  H Forssberg,et al.  Periventricular leucomalacia and preterm birth have different detrimental effects on postural adjustments. , 1999, Brain : a journal of neurology.

[3]  H. Forssberg,et al.  Postural adjustments in sitting humans following external perturbations: muscle activity and kinematics , 2004, Experimental Brain Research.

[4]  O. Nwaobi,et al.  Seating orientations and upper extremity function in children with cerebral palsy. , 1987, Physical therapy.

[5]  M. Hadders‐Algra,et al.  Postural adjustments accompanying fast pointing movements in standing, sitting and lying adults , 1998, Experimental Brain Research.

[6]  L. Wendt,et al.  INFLUENCE OF DIFFERENT SITTING POSITIONS AND ABDUCTION ORTHOSES ON LEG MUSCLE ACTIVITY IN CHILDREN WITH CEREBRAL PALSY , 1993 .

[7]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[8]  E. Flikweert,et al.  Development of postural adjustments during reaching in preterm infants. , 2000, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[9]  M. Hadders‐Algra,et al.  Development of postural adjustments during reaching in infants with CP , 1999, Developmental medicine and child neurology.

[10]  Bert Otten,et al.  Development of postural adjustments during reaching in sitting children , 2003, Experimental Brain Research.

[11]  M. Hadders‐Algra,et al.  Kinematic Quality of Reaching Movements in Preterm Infants , 2003, Pediatric Research.

[12]  B A McClenaghan,et al.  Effects Of Seat‐Surface Inclination On Postural Stability And Function Of The Upper Extremities Of Children With Cerebral Palsy , 1992, Developmental medicine and child neurology.

[13]  M. Sussman,et al.  Electromyographic Investigation of Extensor Activity in Cerebral‐palsied Children in Different Seating Positions , 1983, Developmental medicine and child neurology.

[14]  L. Wendt,et al.  IMPROVEMENT OF FUNCTIONAL SITTING POSITION FOR CHILDREN WITH CEREBRAL PALSY , 1991, Developmental medicine and child neurology.

[15]  M. Hadders‐Algra,et al.  Kinematic Characteristics of Postural Control during Reaching in Preterm Children with Cerebral Palsy , 2005, Pediatric Research.

[16]  O. Nwaobi EFFECTS OF BODY ORIENTATION IN SPACE ON TONIC MUSCLE ACTIVITY OF PATIENTS WITH CEREBRAL PALSY , 1986, Developmental medicine and child neurology.

[17]  Howard Poizner,et al.  Influence of movement speed on accuracy and coordination of reaching movements to memorized targets in three-dimensional space in a deafferented subject , 2003, Experimental Brain Research.

[18]  M. Hadders‐Algra,et al.  Postural control during reaching in preterm children with cerebral palsy. , 2004, Developmental medicine and child neurology.

[19]  M. Hadders‐Algra,et al.  Kinematic Characteristics of Reaching Movements in Preterm Children with Cerebral Palsy , 2005, Pediatric Research.