scholarly journals Postural Dysfunction During Standing and Walking in Children With Cerebral Palsy: What are the Underlying Problems and What New Therapies Might Improve Balance?

2005 ◽  
Vol 12 (2-3) ◽  
pp. 211-219 ◽  
Author(s):  
Marjorie Hines Woollacott ◽  
Anne Shumway-Cook
Keyword(s):  
Cerebral Palsy ◽  
Muscle Activation ◽  
Center Of Pressure ◽  
School Age Children ◽  
Muscle Response ◽  
Balance Recovery ◽  
Response Characteristics ◽  
Ankle Muscles ◽  
Children With Cerebral Palsy ◽  
Response Organization

In this review we explore studies related to constraints on balance and walking in children with cerebral palsy (CP) and the efficacy of training reactive balance (recovering from a slip induced by a platform displacement) in children with both spastic hemiplegic and diplegic CP. Children with CP show (a) crouched posture, contributing to decreased ability to recover balance (longer time/increased sway); (b) delayed responses in ankle muscles; (c) inappropriate muscle response sequencing; (d) increased coactivation of agonists/antagonists. Constraints on gait include (a) crouched gait; (b) increased co-activation of agonists/antagonists; (c) decreased muscle activation; (d) spasticity. The efficiency of balance recovery can be improved in children with CP, indicated by both a reduction in the total center of pressure path used during balance recovery and in the time to restabilize balance after training. Changes in muscle response characteristics contributing to improved recovery include reductions in time of contraction onset, improved muscle response organization, and reduced co-contraction of agonists/antagonists. Clinical implications include the suggestion that improvement in the ability to recover balance is possible in school age children with CP.

scholarly journals Backward walking highlights gait asymmetries in children with cerebral palsy

2018 ◽  
Vol 119 (3) ◽  
pp. 1153-1165 ◽  
Author(s):  
Germana Cappellini ◽  
Francesca Sylos-Labini ◽  
Michael J. MacLellan ◽  
Annalisa Sacco ◽  
Daniela Morelli ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Muscle Activation ◽  
Pattern Generation ◽  
Comprehensive Assessment ◽  
Emg Activity ◽  
Backward Walking ◽  
Spinal Circuitry ◽  
Children With Cerebral Palsy ◽  
Control Circuits ◽  
The Brain

To investigate how early injuries to developing motor regions of the brain affect different forms of gait, we compared the spatiotemporal locomotor patterns during forward (FW) and backward (BW) walking in children with cerebral palsy (CP). Bilateral gait kinematics and EMG activity of 11 pairs of leg muscles were recorded in 14 children with CP (9 diplegic, 5 hemiplegic; 3.0–11.1 yr) and 14 typically developing (TD) children (3.3–11.8 yr). During BW, children with CP showed a significant increase of gait asymmetry in foot trajectory characteristics and limb intersegmental coordination. Furthermore, gait asymmetries, which were not evident during FW in diplegic children, became evident during BW. Factorization of the EMG signals revealed a comparable structure of the motor output during FW and BW in all groups of children, but we found differences in the basic temporal activation patterns. Overall, the results are consistent with the idea that both forms of gait share pattern generation control circuits providing similar (though reversed) kinematic patterns. However, BW requires different muscle activation timings associated with muscle modules, highlighting subtle gait asymmetries in diplegic children, and thus provides a more comprehensive assessment of gait pathology in children with CP. The findings suggest that spatiotemporal asymmetry assessments during BW might reflect an impaired state and/or descending control of the spinal locomotor circuitry and can be used for diagnostic purposes and as complementary markers of gait recovery.NEW & NOTEWORTHY Early injuries to developing motor regions of the brain affect both forward progression and other forms of gait. In particular, backward walking highlights prominent gait asymmetries in children with hemiplegia and diplegia from cerebral palsy and can give a more comprehensive assessment of gait pathology. The observed spatiotemporal asymmetry assessments may reflect both impaired supraspinal control and impaired state of the spinal circuitry.

scholarly journals The Rehabilitative Effects of Virtual Reality Games on Balance Performance among Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 16 (21) ◽  
pp. 4161 ◽  
Author(s):  
Jinlong Wu ◽  
Paul D. Loprinzi ◽  
Zhanbing Ren
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Controlled Trials ◽  
Balance Recovery ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy ◽  
The Impact

This research aims to evaluate the effect of virtual reality (VR) games on balance recovery of children with cerebral palsy (CP) by quantitatively synthesizing the existing literature, and to further determine the impact of VR game intervention (the duration of each intervention, intervention frequency, intervention cycle, and total intervention time) on the balance recovery of children with CP. To this end, relevant literature up until 3 August 2019 was retrieved from Chinese databases (CNKI and Wanfang Data) and the databases in other languages (Web of Science, Pubmed, EBSCOhost, Informit, Scopus, Science Direct, and ProQuest), and bias analysis was conducted with the PEDro scale in this research. Randomized controlled trials (RCTs) were selected and underwent meta-analysis, and combined effect size was calculated with a random effects model. The results showed that VR games may improve the balance of children with CP (Hedge’s g = 0.29; 95% CI 0.10–0.48), and no significant influence of the intervention on balance of children with CP was shown in the subgroup analysis. In conclusion, VR games played a positive role in the improvement of balance of children with CP, but these results should be viewed with caution owing to current methodological defects (difference in measurement, heterogeneity of control groups, intervention combined with other treatments, etc.).

The validity and reliability of modelled neural and tissue properties of the ankle muscles in children with cerebral palsy

2015 ◽  
Vol 42 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Lizeth H. Sloot ◽  
Marjolein M. van der Krogt ◽  
Karin L. de Gooijer-van de Groep ◽  
Stijn van Eesbeek ◽  
Jurriaan de Groot ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Validity And Reliability ◽  
Tissue Properties ◽  
Ankle Muscles ◽  
Children With Cerebral Palsy

Implicit EMG-driven gaming to alter calf muscle activation during gait in children with cerebral palsy

2021 ◽  
Vol 90 ◽  
pp. 61-62
Author(s):  
E. Flux ◽  
L. Bar-On ◽  
A.I. Buizer ◽  
J. Harlaar ◽  
M.M. van der Krogt
Keyword(s):  
Cerebral Palsy ◽  
Muscle Activation ◽  
Calf Muscle ◽  
Children With Cerebral Palsy

scholarly journals Play and Be Happy? Leisure Participation and Quality of Life in School-Aged Children with Cerebral Palsy

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Keiko Shikako-Thomas ◽  
Noémi Dahan-Oliel ◽  
Michael Shevell ◽  
Mary Law ◽  
Rena Birnbaum ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Pearson Correlation ◽  
Leisure Activities ◽  
Multiple Linear Regression Model ◽  
Well Being ◽  
School Age Children ◽  
Leisure Participation ◽  
Children With Cerebral Palsy

The objective of this study was to examine the association between leisure participation and quality of life (QoL) in school-age children with cerebral palsy (CP). Leisure participation was assessed using the Children’s Assessment of Participation and Enjoyment (CAPE) and QoL using the Pediatric Quality of Life Inventory (PedsQL). Pearson correlation coefficients were calculated to examine the association between CAPE and PedsQL scores, and a multiple linear regression model was used to estimate QoL predictors. Sixty-three children (mean age9.7±2.1years; 39 male) in GMFCS levels I–V were included. Intensity of participation in active-physical activities was significantly correlated with both physical (r=0.34,P=0.007) and psychosocial well-being (r=0.31,P=0.01). Intensity and diversity of participation in skill-based activities were negatively correlated with physical well-being (r=−0.39,P=0.001, andr=−0.41,P=0.001, resp.). Diversity and intensity of participation accounted for 32% (P=0.002) of the variance for physical well-being and 48% (P<0.001) when age and gross motor functioning were added. Meaningful and adapted leisure activities appropriate to the child’s skills and preferences may foster QoL.

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