Postural Control in Children with Diplegic Cerebral Palsy: The Association with Cervical Joint Position Sense Error.
Impaired cervical joint position sense is closely linked to lower postural control in children with spastic diplegic cerebral palsy, suggesting that evaluating this sense may improve rehabilitation outcomes.
Where it sits
this study against the rest of the selank corpusSummary and findings
This study examined the relationship between postural control and cervical joint position sense error (CJPSE) in 38 children with spastic diplegic cerebral palsy aged 5-12 years. CJPSE was measured using a Cervical Range of Motion device, while postural control was assessed with the Trunk Control Measurement Scale. Significant negative correlations were found between CJPSE and postural control across various movements.
Abstract
This cross-sectional study aimed to investigate relationship between postural control and cervical joint position sense error (CJPSE) in children with spastic diplegic cerebral palsy (CP).Thirty-eight children with spastic diplegic CP (Gross Motor Function Classification System levels I-III), aged 5-12 years (mean age 7.94 ± 2.87), participated in study. CJPSE was evaluated using Cervical Range of Motion (CROM) device in flexion, extension, right/left rotation, and right/left lateral flexion directions. Postural control was assessed with Trunk Control Measurement Scale (TCMS), and gross motor function was measured by Gross Motor Function Measure-66 (GMFM-66). Correlations between variables were analyzed using Spearman's rank correlation test.Cervical joint position error was negatively correlated with postural control for flexion (<i>r</i>= -0.533, <i>p</i> = 0.001), extension (<i>r</i>= -0.413, <i>p</i> = 0.011), left rotation (<i>r</i>= -0.702, <i>p</i> < 0.001), and lateral flexion (<i>r</i>= -0.660/-0.736, <i>p</i> < 0.001), while right rotation showed small positive correlation (<i>r</i> = 0.350, <i>p</i> = 0.034). Strongest relationships appeared in dynamic sitting subscale of TCMS. Gross motor function was inversely associated with CJPSE error in flexion, left rotation, and lateral flexion movements, particularly in GMFM-C and GMFM-E dimensions.Impaired CJPSE is closely linked to lower postural control and gross motor performance in children with spastic diplegic CP. Incorporating CJPSE evaluation into rehabilitation may enhance functional outcomes.
Background
This study investigates the relationship between postural control and cervical joint position sense error in children with spastic diplegic cerebral palsy. Prior research has indicated that postural control is crucial for functional mobility, and joint position sense may play a role in this. Understanding these relationships could inform rehabilitation strategies for improving motor function in affected children.
Methods
This cross-sectional study included 38 children with spastic diplegic cerebral palsy, aged 5-12 years, with a mean age of 7.94 ± 2.87. CJPSE was evaluated using a Cervical Range of Motion device in multiple directions, while postural control was assessed using the Trunk Control Measurement Scale. Correlations between variables were analyzed using Spearman's rank correlation test.
Results
The strongest negative correlation was found for cervical joint position error in left rotation (r=-0.702, p<0.001) with postural control. Other significant correlations included flexion (r=-0.533, p=0.001), extension (r=-0.413, p=0.011), and lateral flexion (r=-0.660/-0.736, p<0.001). A small positive correlation was observed for right rotation (r=0.350, p=0.034).
Interpretation
These findings suggest that impaired cervical joint position sense is associated with lower postural control and gross motor performance in children with spastic diplegic cerebral palsy. While the correlations are statistically significant, the clinical significance of these findings requires further investigation, particularly given the small sample size and cross-sectional design.
Key findings
- Cervical joint position error negatively correlated with postural control for flexion (r=-0.533, p=0.001).
- Cervical joint position error negatively correlated with postural control for extension (r=-0.413, p=0.011).
- Cervical joint position error negatively correlated with postural control for left rotation (r=-0.702, p<0.001).
- Cervical joint position error negatively correlated with postural control for lateral flexion (r=-0.660/-0.736, p<0.001).
- Right rotation showed a small positive correlation with postural control (r=0.350, p=0.034).
Limitations
- small n=38
- cross-sectional design limits causation inference
- single-site study may affect generalizability