Postural stability in children with hemiplegia estimated for three postural conditions: standing, sitting and kneeling.
Kids with hemiplegia who show an anti-gravity pattern shift too much weight to the strong side—kneeling evens them out.
01Research in Context
What this study did
The team watched kids with hemiplegia stand, sit, and kneel on a force plate.
They tracked how much each child swayed and where they put their weight.
Kids with an anti-gravity pattern were compared with kids who had scoliosis.
What they found
Children with the anti-gravity pattern rocked more and kept more weight on the strong side.
The same kids were steadier in kneeling than in standing.
Results were mixed: some positions helped, but none fixed the asymmetry.
How this fits with other research
Pavão et al. (2013) already showed we can reliably measure sway in CP, but warned most labs skip daily-life tasks.
Medeiros et al. (2015) found that giving support during sit-to-stand cuts sway in CP, backing the idea that external help matters.
Iosa et al. (2012) saw worse gait stability in hemiplegia, so the static asymmetry seen here likely carries over to walking.
Why it matters
You can spot risky asymmetry in under a minute with a bathroom scale or force plate.
If the child bears more than 60% weight on one foot while standing, try kneeling or half-kneel play first.
Share the number with PT: early alignment work may stop bigger gait problems later.
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02At a glance
03Original abstract
Postural control deficit is one of the most important problems in children with cerebral palsy (CP). The purpose of the presented study was to compare the effects of body posture asymmetry alone (i.e., in children with mild scoliosis) with the effects of body posture impairment (i.e., in children with hemiplegia) on postural stability. Forty-five outpatients with hemiplegia and 51 children with mild scoliosis were assessed using a posturography device. The examination comprised two parts: (1) analysis of the static load distribution; and (2) a posturographic test (CoP measurements) conducted in three postural conditions: standing, sitting and kneeling. Based on the asymmetry index of the unaffected/affected body sides while standing, the children with hemiplegia were divided into two different postural patterns: a pro-gravitational postural pattern (PGPP) and an anti-gravitational postural pattern (AGPP) (Domagalska-Szopa & Szopa (2013). BioMed Research International, 2013, 462094; (2014). Therapeutics and Clinical Risk Management, 10, 113). The group of children with mild scoliosis, considered as a standard for static body weight distribution, was used as the reference group. The results of present study only partially confirmed that children with hemiplegia have increased postural instability. Strong weight distribution asymmetry was found in children with an AGPP, which induced larger lateral-medial CoP displacements compared with children with scoliosis. In children with hemiplegia, distinguishing between their postural patterns may be useful to improve the guidelines for early therapy children with an AGPP before abnormal patterns of weight-bearing asymmetry are fully established.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.01.001