Guo S-L1,2, Liu W-Y1,3, Lien H-Y1, Lin Y-H1, Chen F-C1,4, Tsai W-C1,5
1School of Physical Therapy and Graduate Institute of Rehabilitation, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, 2Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, 3Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Lin-Kao, Tao-Yuan, Taiwan, 4Department of Rehabilitation Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan, 5Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
Background: Subjects with unilateral spastic cerebral palsy (USCP) frequently use one hand to perform activities in their daily life. Information on postural adjustments, such as anticipatory postural adjustments (APAs), during unimanual upper extremity task (the affected vs. the less-affected) in subjects with USCP is limited.
Purpose: The purpose of this study was to compare postural adjustments, including APAs, during the affected and the less affected forward reach between subjects with USCP and healthy control subjects.
Methods: Five subjects with USCP (12.7+2.7 years) and five healthy control subjects (12.6+2.2 years) participated in this study. The unilateral forward reaching tasks in sitting were performed by the affected hand and the less-affected hand in random order. Postural adjustments were recorded by using electromyography (EMG) (MA300-XVI, Motion Lab Systems, Baton Rouge, LA, USA) to assess the activation of eight postural muscles, and a 60 cm×60 cm force platform (Bertec Corporation, Columbus, OH, USA) to measure the center of pressure (COP) excursion. A custom-made LabVIEW program (LabVIEW 2014, National Instruments, Austin, TX, USA) was used to conduct off-line data reduction and processing for all EMG and force plate data collected. Descriptive statistics and two-way repeated ANOVA were used for statistical analyses.
Results: Prior to initiating a reaching movement, participants in both groups activated their contralateral erector spinae (ESc) in 49 trials (82%), and showed posterior shift of their COP (COPPost) in 45 trials (75%). Subjects with USCP demonstrated longer absolute time difference between ipsilateral erector spinae (ESi) and reach (p=0.015) than healthy control subjects did, regardless of conditions. While reaching by the affected hand, subjects with USCP appeared to have more difficulty in activing the ESi within the optimal APA period (p=0.035).
Conclusion(s): Subjects with USCP were capable to demonstrate basic spatial pattern of APAs. Despite the small sample size, subjects with USCP demonstrated spatial and temporal dysfunctions in APAs in this study.
Implications: The preliminary findings suggest that not only the affected movement, but also the affected focal arm movement accompanying postural adjustments in subjects with USCP need to be monitored during daily activities. Further study is warranted.
Keywords: Unilateral spastic cerebral palsy, Anticipatory postural adjustments
Funding acknowledgements: The manuscript was partially supported from the Chang Gung Medical Foundation, Taiwan, ROC (BMRP652 and CMRPD160431) to Dr. Liu.
Purpose: The purpose of this study was to compare postural adjustments, including APAs, during the affected and the less affected forward reach between subjects with USCP and healthy control subjects.
Methods: Five subjects with USCP (12.7+2.7 years) and five healthy control subjects (12.6+2.2 years) participated in this study. The unilateral forward reaching tasks in sitting were performed by the affected hand and the less-affected hand in random order. Postural adjustments were recorded by using electromyography (EMG) (MA300-XVI, Motion Lab Systems, Baton Rouge, LA, USA) to assess the activation of eight postural muscles, and a 60 cm×60 cm force platform (Bertec Corporation, Columbus, OH, USA) to measure the center of pressure (COP) excursion. A custom-made LabVIEW program (LabVIEW 2014, National Instruments, Austin, TX, USA) was used to conduct off-line data reduction and processing for all EMG and force plate data collected. Descriptive statistics and two-way repeated ANOVA were used for statistical analyses.
Results: Prior to initiating a reaching movement, participants in both groups activated their contralateral erector spinae (ESc) in 49 trials (82%), and showed posterior shift of their COP (COPPost) in 45 trials (75%). Subjects with USCP demonstrated longer absolute time difference between ipsilateral erector spinae (ESi) and reach (p=0.015) than healthy control subjects did, regardless of conditions. While reaching by the affected hand, subjects with USCP appeared to have more difficulty in activing the ESi within the optimal APA period (p=0.035).
Conclusion(s): Subjects with USCP were capable to demonstrate basic spatial pattern of APAs. Despite the small sample size, subjects with USCP demonstrated spatial and temporal dysfunctions in APAs in this study.
Implications: The preliminary findings suggest that not only the affected movement, but also the affected focal arm movement accompanying postural adjustments in subjects with USCP need to be monitored during daily activities. Further study is warranted.
Keywords: Unilateral spastic cerebral palsy, Anticipatory postural adjustments
Funding acknowledgements: The manuscript was partially supported from the Chang Gung Medical Foundation, Taiwan, ROC (BMRP652 and CMRPD160431) to Dr. Liu.
Topic: Paediatrics: cerebral palsy
Ethics approval required: Yes
Institution: Chang Gung Medical Foundation Institution
Ethics committee: Chang Gung Medical Foundation Institutional Review Board
Ethics number: 101-3405A3
All authors, affiliations and abstracts have been published as submitted.
