Effect of the severity of manual impairment and hand dominance on anticipatory and compensatory postural adjustments during manual reaching in children with cerebral palsy.
Kids with moderate-to-severe CP sway a lot more when they reach with the weaker arm.
01Research in Context
What this study did
Pavão et al. (2018) watched kids with cerebral palsy reach for a toy. They used motion cameras to track body sway.
Each child reached with the better arm and then with the harder arm. Kids were grouped by how much their hands were affected.
What they found
More hand trouble meant more wobble. Using the harder arm made the body sway even bigger.
Typical kids stayed almost still. Kids with moderate-to-severe CP swayed almost twice as much when they used the non-dominant arm.
How this fits with other research
Tomita et al. (2016) saw the same severity link, but during quiet standing. The new study shows the problem also shows up while reaching.
Visicato et al. (2015) already told us CP reaches are jerky. Leticia adds that the body is also rocking, so the arm and trunk problems stack together.
Hattier et al. (2011) found kids with CP fail to tune out big visual cues. That visual tuning issue may feed the extra sway seen here when the task gets harder.
Why it matters
If you work on reaching, check which arm the child uses and how much the trunk moves. Start with the better arm and a stable surface. When you switch to the weaker arm, expect more sway and give trunk support or sit the child down. This keeps therapy safe and lets you focus on smooth arm motion first.
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Join Free →Tape a small target on the table and watch the child’s hips while they reach; if the trunk shifts more than a hand-width, add a chair back or weight belt before continuing.
02At a glance
03Original abstract
AIM: To investigate the role of the severity of manual impairment and of hand dominance on postural sway during anticipatory [APA] and compensatory [CPA] postural adjustments in a seated manual reaching task performed by children with cerebral palsy (CP) and typical children (TC). METHODS: We tested 26 TC (mean age 9.5 ± 2.1 years) and 29 children with CP (age 9.6 ± 3 years) classified based on manual impairment levels as mild (Manual Ability Classification System [MACS] I; n = 18) or moderate-to-severe (MACS II-III, n = 11). Participants were instructed to reach towards a target using their dominant vs. non-dominant arm while sitting on a force-plate. Center of pressure (CoP) sway was analyzed during APA and CPA. RESULTS: For all groups, using the non-dominant arm determined greater amplitude and velocity of CoP sway in CPA. Children with moderate-to-severe manual impairment showed greater sway during APA and CPA compared to mild impairment and TC groups. CONCLUSION: More severe manual impairment resulted in higher sway during the anticipatory and compensatory phases of the reaching task. Using the non-dominant arm resulted in greater compensatory adjustments during reaching.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.08.007