Postural consequences of muscle tone disorders in children with cerebral palsy (hemiparesis)

Andrzej Szopa, Małgorzata Domagalska, Krzysztof Czupryna, Maciej Płaszewski

Andrzej Szopa, Małgorzata Domagalska, Krzysztof Czupryna, Maciej Płaszewski – Postural consequences of muscle tone disorders in children with cerebral palsy (hemiparesis). Fizjoterapia Polska 2007; 7(3); 241-249

Abstract
Background. The spontaneous adjustment of abnormal muscle tone in CP children leads to abnormal postural and motor patterns development. The aim of this work was to recognize and define some of compensatory postural patterns in CP children. Material and methods. The group of 18 children with hemiplegia, aged 5-14, were taken into the examination. The objective measurement of they postural patterns while standing, kneeling (of one and both legs) and sitting was done with a help of photogrammetry. In the same time using baroresistive platform a force distribution on the support base were measured. Results. In case of standing position two kinds of postural patterns were observed — the progravitational pattern and the anti-gravitational pattern. In every children with progravitional pattern lateral spine curvature were observed. Their values were significantly higher than similar in antigravitational pattern. In standing on one leg and half kneeing the arrangement of postural parameters were the same. In sitting in children with progravitional type mutual arrangement of shoulders and pelvis line was changed to parallel and in children with antygravitional type overloaded side changed to opposite. Conclusions. 1. The postural patterns through hemiparetic children are habitual and have differentiated character according to character of paresis. 2. Development of postural patterns is predictable, it is possible to steer the compensation during the treatment.
Key words:
cerebral palsy, compensatory antigravity mechanisms, postural patterns
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Postural problems of children with CP based on hemiparesis

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny – Postural problems of children with CP based on hemiparesis. Fizjoterapia Polska 2008; 8(3); 253-259

Abstract
Background. Injury to the immature brain leads to impaired development of the antigravity mechanism. The adoption of progressively higher body positions is only possible due to compensatory mechanisms. The aim of the study was to diagnose postural disorders in children with CP with respect to the adopted compensatory mechanisms. Material and methods. Eighteen children with advanced hemiparesis, aged from 5 to 14, took part in the study. Objective posturometric measurements were taken while the patients maintained a standing position without assistance. Photogrammetric measurements was used to evaluate the spatial arrangement of individual body segments, with pressure forces on the support base being assessed simultaneously using a baroresistive platform. Results. Patients demonstrated two types of postural patterns: a progravity pattern and an antigravity pattern, which differed mainly in terms of the patient habitually overloading or unloading one of the lower limbs, changing the position of the centre of gravity projection on the support base and a characteristic relation of the shoulder and pelvic lines. Conclusions. The nature of postural disorders in CP children depends on the anti- or progravitational nature of the paresis. The development of postural disorders in CP children is predictable and should therefore be taken into account from the very beginning of rehabilitation
Key words:
cerebral palsy, compensatory antigravity mechanism, postural problems
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