Assessment & Research

The influence of seat heights and foot placement positions on postural control in children with cerebral palsy during a sit-to-stand task.

Medeiros et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

Light support cuts sway in CP sit-to-stand, and a higher seat eases joint load without harming balance.

✓ Read this if BCBAs who teach daily living skills to kids with CP in clinic or school.
✗ Skip if BCBAs working on vocal or social targets only.

01Research in Context

01

What this study did

The team watched the kids do sit-to-stand moves on a force plate. Half had cerebral palsy. Some used hands or furniture for help. Others stood up alone.

They tried two seat heights: low and high. They also moved the kids' feet to three spots. Cameras and plates tracked how far the body swayed and how much the joints bent.

02

What they found

Kids with CP who needed support swayed less than both independent CP peers and typical kids.

Raising the seat cut down hip and knee motion, but it did not change sway size or speed. Foot placement made no clear difference.

03

How this fits with other research

dos Santos et al. (2011) warned that past STS studies used too many methods. The new paper answers that call by using one clear lab setup.

Cheng et al. (2013) showed that locking the lower body helps kids with CP keep their trunk straight while writing. The new study adds that even light hand support can steady the whole body during STS.

Perry et al. (2024) found that adults with Down syndrome sway more than peers. The CP kids here swayed less when they got help. This hints that external support, not diagnosis, may drive sway size.

04

Why it matters

If a child with CP needs help to stand, do not rush to fade that help. The support may be cutting sway and saving energy. Try raising the seat first; it lowers joint strain without hurting balance.

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→ Action — try this Monday

Raise the therapy chair 5 cm and let the child use a hand on the table when practicing stand-ups.

02At a glance

Intervention
not applicable
Design
other
Sample size
28
Population
developmental delay, neurotypical
Finding
mixed

03Original abstract

This paper aimed to analyze, from both a kinetic and kinematic perspective, the postural control of children with cerebral palsy (CP) able to independently perform the sit-to-stand (STS) task (ICP) and children who needed support (SCP) typically developing children during the STS; and also investigate the influence of seats heights and foot placement positions on postural control of these children. Fourteen children with CP and fourteen typically developing controls were recruited. Based on the Gross Motor Function Classification System (GMFCS) the children with CP were divided into ICP (level I) and SCP (levels II and III). Balance was assessed using the Pediatric Balance Scale. Motor function was rated using the GMFCS. Kinematic and kinetic data were recorded and analyzed during the STS task at two different seat heights and foot placement positions. The SCP exhibited significantly less balance according to the PBS and smaller displacement of their center of pressure (COP) in anteroposterior (COPAP) and mediolateral (COPML) direction relative to the other two groups. ICP demonstrated significant greater in the COPML displacement than the other groups. Children with CP required more time to complete the STS than controls. Those in the SCP group had lower linear displacement of the shoulder and knee than others during the STS task. During the high bench condition, the linear displacements of the shoulder and knee were reduced also. We conclude that the SCP has less COPAP and COPML oscillation, what means the better postural control during STS than the other two groups, which may be related to the support provided. The ICP exhibited greater COPML oscillations than controls, suggesting that they utilized different strategies in the frontal plane during the STS task. The seat height and foot placement did not influence postural control in children with CP, at least in terms of kinetic parameters. Seat height influenced the kinematic variables, with a high bench reducing linear displacement of the shoulder (vertical and horizontal) and knee (vertical) both in children with CP and control children.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.05.004