Background: Children with cerebral palsy (CP) have difficulty in managing postural control during functional reaching tasks, although children with different postural control ability are able to come up with different motor solutions to cope with different task demands. This study examined the effect of task constraint on postural control performance in children with cerebral palsy and typical development (TD) in terms of different postural control abilities. Methods: A cross-sectional research design was used. Twelve children with spastic diplegic cerebral palsy (mean age: 107.8 months) and 16 typically developing children (mean age: 110.9 months) participated in this study. Individually, all subjects were seated in a height-adjusted chair and were requested to reach for target(s) located at three different directions (medial, anterior, and lateral). A six-camera Qualisys Motion Capture System was used to capture motion data. Kinematic data in terms of body alignment and angular changes were analyzed. Results: Children with cerebral palsy demonstrated different postural control strategies to complete different reaching tasks compared to typically developing children by preparing postural alignment in advance, coordinating different body orientation movements during reaching after showing difficulty in managing reach medially. Conclusions: Children with cerebral palsy perceive their insufficient ability and prepare their alignment in advance to adapt to the task demanded and decrease the postural challenges of the task. Even though children with cerebral palsy self-generate different motor solutions to reach without falling, these alternative strategies might not be the most efficient adaptation.
Inputs from the visual, somatosensory and vestibular systems must be integrated efficiently to activate appropriate motor responses in maintaining optimal balance. This study examined the standing balance of 17 children (7 to 10 years old) and 17 young adults (19 to 23 years old) as a function of sensory organization, sensory system efficiency, and postural strategy adopted. Tests of standing balance were administered under six sensory conditions created by simultaneous alteration of the visual (full, occluded, or sway-referenced) and the somatosensory inputs (fixed-foot or compliant-foot support). The sway area and the sway amplitude of the center of pressure were measured and analyzed. Three findings are notable. The function of sensory organization for balance control was poorer for the children than the young adults. The functional efficiency of the somatosensory and the visual systems of children have developed to the young adult level, but that of the vestibular system has not. There was no difference between children and young adults in hip control, but there was in ankle control when the vestibular input was the only reliable source of sensory input. These results suggest that the functional efficiency of the vestibular system in children 7 to 10 years of age may still be developing. This may account for their poorer function of sensory organization and lower performance of standing balance.
Background and Purpose: The purposes of the study were to examine the standing balance and the role of visual information for maintaining standing balance in children with developmental coordination disorder (DCD) based on a method of meta-analysis. Methods: An extensive literature search with the key words of DCD, clumsy children, development dyspraxia, minimal brain dysfunction, and physical awkward was undergone on a number of electronic databases including Medline, PsycInfo, PubMed, and ProQuest Digital Dissertations (PQDD). To be included in this meta-analysis, a study needed to: (1) be a comparison study with a group of participants with DCD and a control group; (2) include quantitative measures of balance performance; (3) provide sufficient information to be able to calculate effect size. A correlation coefficient r-indicator was used to represent the effect size of the difference in standing balance between children with and without DCD. Results: Literature search resulted in nine studies. The effect size r of static balance and dynamic balance was 0.32 and 0.38, respectively. The effect size r of balance performance with visual input and without visual input were 0.30 and 0.35, resulting in the effect size of visual input, r=0.05. Conclusion: The results indicate that the balance performance of children with DCD was poorer than that of children without DCD and the effect size was moderate. The effect of visual input on standing balance is not different in children with DCD from children without DCD. Future studies are suggested to investigate the role of other sensory inputs or the function of sensory organization for maintaining standing balance in children with DCD.
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