1. Effects of forward tilted seating and foot-support on postural adjustments in children with spastic cerebral palsy: An EMG-study.
- Author
-
Angsupaisal M, Dijkstra LJ, la Bastide-van Gemert S, van Hoorn JF, Burger K, Maathuis CGB, and Hadders-Algra M
- Subjects
- Biomechanical Phenomena, Cerebral Palsy rehabilitation, Child, Electromyography, Female, Humans, Male, Cerebral Palsy physiopathology, Orthotic Devices, Posture physiology, Psychomotor Performance physiology
- Abstract
Objective: To evaluate the effect of 15° forward (FW) seat inclination and foot-support in children with cerebral palsy (CP) on postural adjustments during reaching., Design: Observational study repeated-measures design; step two of two-step-project., Setting: Laboratory unit within University Hospital and two special education schools., Participants: 19 children (ten unilateral spastic CP (US-CP); nine bilateral spastic CP (BS-CP); Gross Motor Function Classification System levels I-III; 6-12 years old). Participants were able to take part for one one-hour session., Intervention: Reaching while sitting in four seating conditions (FW or horizontal seat; with or without foot-support) applied in randomized order., Outcome Measures: Simultaneously, surface electromyography (EMG) of neck, trunk and arm muscles and kinematics of head and reaching arm (step one of two-step-project) were recorded. Primary outcome parameters were the ability to modulate EMG-amplitudes at baseline and during reaching (phasic muscle activity). Other EMG-parameters were direction-specificity (1st control level), and 2nd level of control parameters: recruitment order, and anticipatory postural activity. Motor behaviour measures: ability to modulate EMG-amplitudes to kinematic characteristics of reaching and head stability., Results: Only foot-support was associated with increased tonic background EMG-amplitudes and decreased phasic EMG-amplitudes of the trunk extensors in children with US-CP and BS-CP (mixed-models analyses; p-values <0.01). The foot-support effect was also associated with better kinematics of reaching (Spearman's Rho; p-values <0.01)., Conclusion: In terms of postural adjustments during forward reaching, foot-support enhanced the children's capacity to modulate trunk extensor activity, which was associated with improved reaching quality. FW-tilting did not affect postural muscle activity., (Copyright © 2019 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF