Anteroposterior balance reactions in children with spastic cerebral palsy.

ABSTRACT:

Aim

To compare anterior and posterior standing balance reactions, as measured by single-stepping thresholds, in children with and without spastic cerebral palsy (CP).

Method

Seventeen ambulatory children with spastic CP (eight males, nine females) and 28 typically developing children (13 males, 15 females; age range 5-12y, mean [SD] 9y 2mo [2y 3mo]), were included in this cross-sectional, observational study. Balance reaction skill was quantified as anterior and posterior single-stepping thresholds, or the treadmill-induced perturbations that consistently elicited a step in that direction. In order to understand the underlying mechanisms of between-group differences in stepping thresholds, dynamic stability was quantified using the minimum margin of stability. Ankle muscle activation latency, magnitude, and co-contraction were assessed with surface electromyography.

Results

We observed an age and group interaction for anterior thresholds (p=0.001, partial η² =0.24). At older (≈11y; p<0.001, partial η² =0.48), but not younger (≈7y; p=0.33, partial η² =0.02) ages, typically developing children had larger anterior thresholds than those with CP. In response to near-threshold anterior perturbations, older typically developing children recovered from more instability than their peers with CP (p=0.004, partial η² =0.18). Older children had no between-group differences in ankle muscle activity. No between-group differences were observed in posterior thresholds.

Interpretation

The effects of CP on balance reactions are age- and direction-specific. Older typically developing children are more able or willing to withhold a step when unstable.

What this paper adds

Children with spastic cerebral palsy have age- and direction-specific balance-reaction impairments. Lower anterior stepping thresholds were observed in older, but not younger children. Older typically developing children withheld a forward step at higher levels of instability. No between-group differences were seen in posterior stepping thresholds.

SUBMITTER: Crenshaw JR 

PROVIDER: S-EPMC7916524 | biostudies-literature |

REPOSITORIES: biostudies-literature