Postural stability in children with hemiplegia estimated for three postural conditions: Standing, sitting and kneeling

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.