Effects of forward tilted seating and foot-support on postural adjustments in children with spastic cerebral palsy: An EMG-study

Angsupaisal, M., Dijkstra, L-J., la Bastide-van Gemert, S., van Hoorn, J. F., Burger, K., Maathuis, C. G. B. & Hadders-Algra, M., Sep-2019, In : European Journal of Paediatric Neurology. 23, 5, p. 723-732 10 p.

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  • Effects of forward tilted seating and foot-support on postural adjustments in children with spastic cerebral palsy An EMG-study

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OBJECTIVE: To evaluate the effect of 15° forward (FW) seat inclination and foot-support in children with cerebral palsy (CP) on postural adjustments during reaching.

DESIGN: Observational study repeated-measures design; step two of two-step-project.

SETTING: Laboratory unit within University Hospital and two special education schools.

PARTICIPANTS: 19 children (ten unilateral spastic CP (US-CP); nine bilateral spastic CP (BS-CP); Gross Motor Function Classification System levels I-III; 6-12 years old). Participants were able to take part for one one-hour session.

INTERVENTION: Reaching while sitting in four seating conditions (FW or horizontal seat; with or without foot-support) applied in randomized order.

OUTCOME MEASURES: Simultaneously, surface electromyography (EMG) of neck, trunk and arm muscles and kinematics of head and reaching arm (step one of two-step-project) were recorded. Primary outcome parameters were the ability to modulate EMG-amplitudes at baseline and during reaching (phasic muscle activity). Other EMG-parameters were direction-specificity (1st control level), and 2nd level of control parameters: recruitment order, and anticipatory postural activity. Motor behaviour measures: ability to modulate EMG-amplitudes to kinematic characteristics of reaching and head stability.

RESULTS: Only foot-support was associated with increased tonic background EMG-amplitudes and decreased phasic EMG-amplitudes of the trunk extensors in children with US-CP and BS-CP (mixed-models analyses; p-values <0.01). The foot-support effect was also associated with better kinematics of reaching (Spearman's Rho; p-values <0.01).

CONCLUSION: In terms of postural adjustments during forward reaching, foot-support enhanced the children's capacity to modulate trunk extensor activity, which was associated with improved reaching quality. FW-tilting did not affect postural muscle activity.

Original languageEnglish
Pages (from-to)723-732
Number of pages10
JournalEuropean Journal of Paediatric Neurology
Issue number5
Early online date1-Aug-2019
Publication statusPublished - Sep-2019

ID: 94402936