Deficits in upper limb position sense of children with Spastic Hemiparetic Cerebral Palsy are distance-dependent.
Kids with spastic hemiparetic CP lose track of where their arm is, and the gap widens with longer moves—so check position sense early.
01Research in Context
What this study did
The team asked kids to copy an arm position without looking.
They tested children with spastic hemiparetic cerebral palsy and kids with typical development.
The moves were short, medium, or long distances.
Errors were measured in degrees.
What they found
Children with SHCP missed the target by a lot.
The bigger the move, the bigger the miss.
Spasticity and tight joints did not predict the errors.
The sense of limb position, not muscle stiffness, drove the problem.
How this fits with other research
Westendorp et al. (2014) saw 3–4 year lags in gross motor skills in kids with learning disorders.
Both studies show large motor gaps, but P et al. point to a sensory cause while Marieke point to slow skill growth.
Micheletti et al. (2025) found that some kids with CP also have visual-perceptual issues.
Together the papers warn: check both vision and proprioception before blaming weakness or spasticity.
Why it matters
Before you teach reach, grasp, or handwriting, test how well the child knows where their arm is in space.
Use short, medium, and long reaches during assessment.
If errors grow with distance, add proprioceptive training, not just stretching or strengthening.
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02At a glance
03Original abstract
This study examined the arm position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and typically developing children (TD) by means of a contralateral matching task. This task required participants to match the position of one arm with the position of the other arm for different target distances and from different starting positions. Results showed that children with SHCP exhibited with both arms larger matching errors than the TD group, but only when the distance between the arms at the start of the movement was large. In addition, the difference in errors between the less-impaired and the impaired limb changed as a function of the distance in the SHCP group whereas no interlimb differences were found in the TD group. Finally, spasticity and restricted range of motion in children with SHCP were not related to the proportion of undershoot and size of absolute error. This suggests that SHCP could be associated with sensory problems in conjunction with their motor problems. In conclusion, the current study showed that accurate matching of the arms is greatly impaired in SHCP when compared to TD children, irrespective of which arm is used. Moreover, this deficit is particularly present for large movement amplitudes.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.01.006