Search

We investigated factors related to postural sway during sit-to-stand movement in children and adolescents with Down syndrome (DS). Our assessment of participants followed the biopsychosocial model. Body function and structure were represented by muscle strength and postural sway during sit-to-stand movement, which were assessed by manual muscle testing and kinetics analysis, respectively. The Gross Motor Function Measure and Pediatric Balance Scale depicted the activity component. In addition, we included these relevant contextual factors: age, Home Observation for Measurement of the Environment, family income, and maternal schooling. A correlation analysis verified a suspected association between biopsychosocial and postural sway variables. There were significant separated correlations between postural sway in the three phases of the sit-to-stand movement, and age, GMFM-88 dimension D, and muscle strength. Thus, postural control in sit-to-stand movement was related to biopsychosocial factors involving different life aspects of children and adolescents with DS, and these factors should be addressed in rehabilitation therapy intended to improve postural control among these individuals.

Background We aimed to compare motor strategies adopted by children with unilateral Cerebral Palsy and typically developing children during the performance of sit-to-stand. Methods Eleven children with unilateral cerebral palsy and 20 typically developing children were evaluated. Kinematic and kinetic analysis of the sit-to-stand movement was performed. Three seat heights were evaluated: neutral (90° of hip-knee-ankle flexion), elevated to 120% of the neutral height, and lowered to 80% of the neutral height. As outcome variables, we considered sit-to-stand duration (temporal); initial, final and maximal sagittal angles and range of motion of trunk, pelvis, hip, knee, and ankle (kinematics); the peak of vertical ground reaction force (kinetics), and asymmetric index. Effect size is represented by η2p. Findings We found that for the lowered seat, all groups presented increased flexion of lower limbs and trunk to initiate sit-to-stand (p≤0.012; η2p = 0.41–0.84), increased peak flexion of trunk, hip and knee (p≤0.01; η2p = 0.39–0.88), increased range of motion of knee and trunk (p≤0.01; η2p = 0.45–0.85) and the duration of sit-to-stand (p≤0.05 η2p = 0.23–0.56). Children with unilateral cerebral palsy presented increased posterior pelvic tilt (p≤0.01) and decreased hip flexion of both lower limbs (p≤0.01) for all seat heights and moved their non-affected limb backward in the lowered seat (p≤0.01). Asymmetry was observed for the final and the maximal angles of the ankle in neutral and lowered seats in unilateral cerebral palsy (asymmetry index = 3.3–5.8%). Interpretation The lowered seat height led to adaptive motor strategies in children with unilateral cerebral palsy, which should be considered in clinical practice.

Introduction Based on the assumption that motor actions result from the interaction between cognitive, perceptual, mechanical and neurological mechanisms, neuromotor dysfunctions are expected to impair central coordination processes required to perform dual-tasks. The aim of the present work was to systematically review the literature concerning the effects of dual-task in the activities performed by children with neuromotor dysfunctions. Evidence acquisition A tailored search strategy in relevant databases was conducted by two independent reviewers in August 2018 seeking for online articles published in English evaluating dual-task (motor-motor, cognitive-cognitive or cognitive-motor) effects on activities in subjects with neuromotor dysfunctions younger than 18 years. The following data were extracted: category of dual-task paradigm (motor-motor; cognitive-cognitive; cognitive-motor), primary and secondary tasks, study methods, methodological quality of the studies, and research gaps in the literature. Evidence synthesis We identified 13 full-text reports that fulfilled the predefined inclusion and exclusion criteria. Conclusions There are a few high-quality studies addressing dual-task effects on activities performed by children with neuromotor dysfunctions. These children show greater susceptibility to dual-task costs than typical ones. There is a lack of studies addressing children with CP and Down Syndrome, which are highly prevalent and commonly seen in clinical settings. Thus, dual-task effects in children with neuromotor dysfunctions remain a wide research field, with need for further studies to fill in the existing gaps.

Background Cognitive and postural tasks require common cognitive mechanisms, resulting in conflicts when both tasks are simultaneously performed. The presence of neuromotor dysfunctions, such as Down syndrome, may impair coordination processes required to perform dual-tasks. The objective of this study was to investigate the dual-task effects on postural sway during sit-to-stand movements in typical children and children with Down syndrome in a cross-sectional study. Methods Twenty six typical children (10.2 ± 2.4 years) and 21 with Down syndrome (10.3 ± 2.3 years) performed sit-to-stand in the following conditions: (1) simple task; (2) dual-task bimanual activity (DT-Bim): sit-to-stand while carrying a tray using both hands; (3) dual-task unimanual dominant activity (DT-Uni-Dom): sit-to-stand while holding a plastic cup simulating water using the dominant hand; (4) dual-task unimanual non-dominant activity (DT-Uni-Nondom): sit-to-stand movement while holding a plastic cup simulating water. For data analysis, sit-to-stand was divided into three phases: preparation (phase 1), rising (phase 2), and stabilisation (phase 3). The following variables were calculated for each phase: anterior-posterior and medial-lateral amplitude of centre-of-pressure displacement, anterior-posterior and medial-lateral velocity of centre-of-pressure sway and area of centre-of-pressure sway. Results Children with Down syndrome showed greater sway than typical children in all sit-to-stand phases. Typical children showed greater anterior-posterior amplitude in phase 2 of sit-to-stand during DT-Uni Nondom compared with DT-Uni Dom. Children with Down syndrome during simple task condition showed greater and faster values sway in phases 2 and 3 of sit-to-stand movement than in DT-Bim activity, DT-Uni Dom activity and DT-Uni Nondom activity. During the condition of DT-Bim activity, these children showed lower anterior-posterior velocity of sway in phase 2 than during DT-Uni Dom activity. Conclusions Children with Down syndrome showed greater postural sway during sit-to-stand than typical children. The addition of a concurrent motor task to sit-to-stand impacted postural sway in different intensities and in different ways across groups. Dual-tasks increased body sway in typical children in the DT-Uni Nondom condition compared with dominant one. In children with Down syndrome, dual-tasks decreased body sway, apparently resulting in a postural strategy of stiffness.