Impaired postural control of axial segments in children with cerebral palsy

• Published in: Gait & posture Vol. 86; pp. 266 - 272
• Main Authors: Pierret, Jonathan, Caudron, Sébastien, Paysant, Jean, Beyaert, Christian
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01-05-2021; Elsevier
• Subjects: Axial segments; Cerebral palsy; Cognitive science; Postural control; Postural development; Psychology; Unstable sitting; Cerebral palsy; SSB; CoP; Unstable sitting; SMC; EO; CP; DR; TD; Postural development; TCMS; ANOVA; Postural control; RMS; Axial segments; GMFCS; EC
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2021.03.012

•Trunk and head control was specifically assessed in children with cerebral palsy (CP).•An unstable sitting device and the Trunk Control Measurement Scale (TCMS) were used.•CP group have axial segments stabilization disorders compared to TD group.•Axial control deficit may contribute to postural control impairment in CP children.•TCMS scores are correlated to postural sway during sitting and standing tasks.
Sensorimotor control of axial segments, which develops during childhood and is not mature until adolescence, is essential for the development of balance control during motor activities. Children with cerebral palsy (CP) have deficits in postural control when standing or walking, including less stabilization of the head and trunk which could affect postural control.
Is dynamic stabilization of axial segments during an unstable sitting task deficient in children with CP compared to typically developing children? Is this deficit correlated with the deficit of postural control during standing?
Seventeen children with CP (GMFCS I-II) and 17 typically-developing children from 6 to 12 years old were rated on the Trunk Control Measurement Scale (TCMS). In addition, posturography was evaluated in participants while they maintained their balance in stable sitting, unstable sitting, and quiet standing, under “eyes open” and “eyes closed” conditions. In sitting tasks, the participants had to remain stable while being prevented from using the lower and upper limbs (i.e. to ensure the involvement of axial segments alone).
Children with CP compared to TD children had significantly larger surface area, mean velocity and RMS values of CoP displacements measured during the unstable sitting task and the standing task, under both “eyes open” and “eyes closed” conditions. No significant group effects were observed during the stable sitting task. The TCMS total score was significantly lower, indicating trunk postural deficit, in the CP group than in the TD group and was significantly correlated with postural variables in the sitting and standing tasks.
Children with CP indeed have a specific impairment in the postural control of axial segments. Since the postural control of axial segments is important for standing and walking, its impairment should be taken into account in rehabilitation programs for children with CP.