Brink Y.1, Cockcroft J.2, Seedat S.3, May P.4, Kalberg W.5, Louw Q.1
1Stellenbosch University, Division of Physiotherapy, Cape Town, South Africa, 2Stellenbosch University, Unit for Human Movement Analysis, Central Analytical Facility, Cape Town, South Africa, 3Stellenbosch University, Department of Psychiatry, Cape Town, South Africa, 4University of North Carolina, Department of Nutrition, Gillings School of Global Public Health, Kannapolis, United States, 5The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, United States
Background: Foetal Alcohol Spectrum Disorders (FASD) are the most common birth defect in South Africa. Postural control may be impaired in children with FASD. To date, there is no information on the postural stability of South African children with FASD.
Purpose: The study aimed to assess the feasibility of the study protocol in terms of
1) recruiting children with FASD in a rural small town;
2) using the measurement instruments in a real-life setting;
3) the one-leg-standing (OLS) task; and
4) to present preliminary results on postural stability of children with and without FASD.
1) recruiting children with FASD in a rural small town;
2) using the measurement instruments in a real-life setting;
3) the one-leg-standing (OLS) task; and
4) to present preliminary results on postural stability of children with and without FASD.
Methods: A descriptive study was conducted. Nine-year-old children attending rural schools diagnosed with and without FASD were invited to participate. Twenty-eight children participated and performed OLS. Inertial motion trackers and a pressure mat were used. Feasibility outcomes included recruitment, measurement instrument use and task instruction. Postural stability outcomes included standing duration, centre of pressure (COP) movement and body segment acceleration.
Results: Recruitment was feasible. The instruments were user friendly, cost effective and time efficient. The instructions for the task require amendment to address foot placement and positioning of the non-weight bearing leg. There was a significant difference in mean COP velocity and acceleration of the pelvis segment during OLS with eyes open. The control children took longer to achieve postural control and this could be attributed to gender differences. The girls demonstrated a significant difference for the COP anterior/posterior displacement (p=0.008) and velocity (p=0.049), indicating that case girls showed larger anterior/posterior displacement and were slower to achieve postural control than control girls. The control girls could stand on one leg significantly longer than affected girls (p=0.041) during the eyes closed trails. There were no differences in the COP and 3D accelerometry between the two groups for OLS with eyes closed.
Conclusion(s): The study proved the feasibility of
1) recruiting children with and without FASD in a rural small town;
2) using the measurement instruments in a real-life school-based setting and
3) performing the OLS task.
The preliminary findings indicate that there is a difference in mean COP velocity and dynamic acceleration of the pelvis between children with FASD compared to children without FASD during OLS with eyes open and could be attributed to gender differences and the manner in which the OLS task was performed. The primary challenge for the proposed larger study is revision of how the task is performed to ensure that a larger proportion of trials are eligible for inclusion in the data analysis.
Implications: Recruitment and use of the instruments are feasible. Instructions during the OLS task require revision. The preliminary findings indicate a difference in COP and 3D accelerometry parameters between children with FASD compared to children without FASD during OLS with eyes open. Thus, further investigation with larger sample sizes are indicated.
Funding acknowledgements: Funding was provided by the National Research Foundation, Stellenbosch University and the Fund for Innovation and Research in Rural Health.
Topic: Human movement analysis
Ethics approval: Institutional ethical approval form Stellenbosch University (N13/10/140) and permission from the Western Cape Department of Education were obtained.
All authors, affiliations and abstracts have been published as submitted.
