Dynamic and Static Stability in Para-Athletes with Cerebral Palsy Considering their Impairment Profile.

BACKGROUND Balance impairment is a common feature in people with cerebral palsy (CP), impacting the performance of daily-life and physical activities. OBJECTIVES This study aimed to (a) explore the absolute and relative intra-session reliability of two balance tests to assess dynamic and static balance in ambulant para-athletes with CP; (b) explore the relationships between the two balance tests to determine its potential application in sport classification; (c) assess the differences between CP profiles (i.e. spastic diplegia, athetosis/ataxia, and spastic hemiplegia) in comparison to those with a minimum impairment; and (d) compare the outcomes of the static and dynamic balance of ambulant para-athletes with CP regarding controls. METHODS A group of 129 male well-trained para-footballers with CP, classified as level I according to the Gross Motor Function Classification System, participated in the present study. Static balance was assessed using the One-Leg Stance test (OLS), performed bilaterally on a force platform, while the dynamic balance was assessed in two conditions of the Tandem Walk test (TW): walking heel-toe contact over a 5m straight line and performing 10 steps. RESULTS Moderate-to-excellent intra-session reliability (ICC = 0.60-0.98) was obtained for all the measurements and groups. However, only small-to-moderate correlations were found between the dynamic and the static measurements of balance for the CP group when performing the OLS test with the unimpaired or dominant leg (0.23 < r < 0.30; p < 0.01). The TW performed over 10 steps revealed more sensitivity to discriminate between CP profiles. Those para-athletes with ataxia/athetosis performed worse in all the tests while all the CP profiles performed worse than the control group (p < 0.01). CONCLUSIONS Balance performance and postural control are constrained to a higher extent in those with impaired voluntary control due to ataxia or with involuntary contractions of the muscles due to athetosis. This article is protected by copyright. All rights reserved.