Effects of sensory manipulations on the dynamical structure of center-of-pressure trajectories of children with cerebral palsy during sitting.

AIM: To investigate the effects of manipulating visual information and the compliance of the support surface on the area of sway and dynamical trajectories of center-of-pressure (CoP) in children with CP and children with typical development during static sitting. METHODS: 32 typical children, 14 children with mild CP and 12 with moderate-to-severe CP were tested for CoP sway during static sitting under four sensory conditions: (1) eyes open on a rigid surface; (2) eyes closed on a rigid surface; (3) eyes open on foam; (4) eyes closed on foam. RESULTS: Children with moderate-to-severe CP showed greater regularity and local stability of dynamical CoP trajectories and lower complexity in their motor patterns than typical children and children with mild CP. Moreover, removing vision and sitting on a compliant surface reduced the regularity of CoP trajectories. CONCLUSION: Children with CP were able to adjust the structure and complexity of their postural control responses to sensory challenges, although the structure of their postural responses was poorer than in typical children.

Effects of Suit-Orthosis on Postural Adjustments During Seated Reaching Task in Children With Cerebral Palsy.

AIM: To investigate suit-orthosis effects on postural sway during anticipatory and compensatory postural adjustments (APA and CPA, respectively) in a seated reaching task performed by children with cerebral palsy (CP). METHODS: Twenty-nine children were divided according to Manual Ability Classification System (MACS) I and II-III. Participants were instructed to reach forward toward an object both in a no-suit condition and in a suit-orthosis condition. RESULTS: Using the suit-orthosis, children at MACS II-III decreased velocity of center-of-pressure (CoP) sway during APA, whereas children at MACS I increased the anterior-posterior CoP displacement during CPA. CONCLUSION: Suit-orthosis improved postural stability in children at MACS II-III during APA. The suit may assist with arm function control during postural sway when preparing to reach for objects. CLINICAL IMPLICATIONS: Suit-orthoses in therapy should be individually prescribed considering the intended activity and person's motor impairment.

Evaluation and characterization of manual reaching in children with cerebral palsy: A systematic review.

Manual reaching is used daily to perform manipulative tasks and activities of daily routine. Children with cerebral palsy (CP) have limitations in this activity, with functional loss as a possible consequence. This review aimed to gather studies that evaluated and characterized manual reaching in children with CP, with the purpose of identifying the aspects analyzed, as well as review and discuss the results in the studies and its relationship to the children's level of functionality. 17 studies were selected for this systematic review from the search in electronic databases. The studies showed that children with CP show deficits in several spatio-temporal variables of reaching compared to typical children, such as longer time to perform the activity, higher peak velocity, lower index of curvature, and greater number of units of motion, which indicates lower smoothness and linearity of the movements of upper limbs. The performance is influenced by the level of motor impairment and various manipulations of the task. However, more studies are needed that help translating these results into treatment strategies that facilitate the performance of manual activities in children with CP.

Proposta de atuação fisioterapêutica em uma criança com síndrome de Angelman, enfatizando o equilíbrio postural: estudo de caso / Proposal for a physical therapy program in a child with Angelman syndrome, emphasizing postural balance: a case study / Propuesta de actuación fisioterapéutica en un niño con Síndrome de Angelman, enfatizando el equilibrio postural: estudio de caso

A síndrome de Angelman (SA) é caracterizada por alterações neuromotoras como marcha atáxica e atraso na aquisição de habilidades motoras, porém são escassos os estudos investigando o efeito de intervenções aplicadas a essa população. O objetivo do estudo foi verificar o efeito de um treino de equilíbrio em uma criança com SA. Participou do estudo uma criança de nove anos de idade com diagnóstico de SA, sexo feminino. Foi aplicado um protocolo para treino de equilíbrio por oito semanas, com frequência de duas vezes por semana. O treino consistiu em atividades envolvendo equilíbrio estático sob diversas condições de dificuldade. Após o treino, a análise de biofotogrametria computadorizada do equilíbrio estático revelou redução do grau de oscilação, que passou de 38° para 13,78°. A pontuação na escala de Berg passou de 27 pontos, na avaliação, para 37 pontos na reavaliação. No teste Timed Up & Go, a criança realizou a tarefa em 15 segundos, na avaliação, e, na reavaliação, em 12 segundos. Em conjunto, os resultados sugerem que o treino favoreceu melhora no equilíbrio estático e dinâmico, bem como na mobilidade funcional.

The Angelman syndrome is characterized by neuromotor difficulties, such as ataxic gait and delayed acquisition of motor skills. However, there are few studies investigating the effect of interventions directed to this population. This study aimed to investigate the effect of a balance training in a child with Angelman syndrome. The participant was a nine-year-old girl. The training protocol was implemented during an eight-week period, twice a week, and consisted of activities involving static balance under various difficulty levels. After the training, the postural sway measured by biophotogrammetry changed from 38° to 13.78°. The scores in the Berg scale changed from 27 points to 37 points. In the Timed Up & Go test, the child's time to complete the task changed from 15 to 12 seconds. Taken together, the results suggest that the training led to improved static and dynamic balance, as well as functional mobility.

El síndrome de Angelman (SA) es caracterizado por alteraciones neuromotoras como marcha atáxica y atraso en la adquisición de habilidades motoras, pero son escasos los estudios investigando el efecto de intervenciones aplicadas a esta población. El objetivo de este estudio fue verificar el efecto de un entrenamiento del equilibrio en un niño con SA. Participó del estudio un niño de 9 años de edad con diagnóstico de SA, sexo femenino. Fue aplicado un protocolo de entrenamiento para el equilibrio por 8 semanas, con frecuencia de 2 veces por semana. El entrenamiento consistió en actividades involucrando el equilibrio estático sobre diversas condiciones de dificultad. Después del entrenamiento el análisis de biofotogrametría computarizada del equilibrio estático reveló reducción de los grados de oscilación, que pasó de 38° para 13,78°. La puntuación en la escala de Berg pasó de 27 puntos en la evaluación para 37 puntos en la reevaluación. En el test Timed up and go la niña realizó la tarea en 15 segundos en la evaluación y 12 segundos en la reevaluación. En conjunto, los resultados sugieren que el entrenamiento favoreció la mejora en el equilibrio estático y dinámico, así como de la movilidad funcional.