Asymmetry in children with unilateral cerebral palsy during sit-to-stand movement: Cross-sectional,repeated-measures and comparative study |
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| Institution: | 1. Department of Physiotherapy, Universidade Federal de São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil;2. Department of Health Science, Universidade Federal de Santa Catarina, Rod. Governador Jorge Lacerda, n° 3201 - Km 35, 4, 88905-355 Araranguá, SC, Brazil;1. Federal University of São Paulo, Rua Silva Jardim, 136 - Vila Mathias, Santos, SP 11015-020, Brazil;2. Department of Human Movement Science, Federal University of São Paulo, Rua Silva Jardim, 136 - Vila Mathias, Santos, SP 11015-020, Brazil;1. Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, São Carlos, Brazil;2. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA;3. Department of Human Movement Sciences, Federal University of São Paulo, Edifício Central - R. Silva Jardim, 136, Vila Matias, Santos, Brazil;1. Department of Physiotherapy, Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan;2. Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States;3. Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States;4. Department of Physical Therapy, University of Delaware, Newark, DE, United States |
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| Abstract: | BackgroundWe aimed to compare motor strategies adopted by children with unilateral Cerebral Palsy and typically developing children during the performance of sit-to-stand.MethodsEleven children with unilateral cerebral palsy and 20 typically developing children were evaluated. Kinematic and kinetic analysis of the sit-to-stand movement was performed. Three seat heights were evaluated: neutral (90° of hip-knee-ankle flexion), elevated to 120% of the neutral height, and lowered to 80% of the neutral height. As outcome variables, we considered sit-to-stand duration (temporal); initial, final and maximal sagittal angles and range of motion of trunk, pelvis, hip, knee, and ankle (kinematics); the peak of vertical ground reaction force (kinetics), and asymmetric index. Effect size is represented by η2p.FindingsWe found that for the lowered seat, all groups presented increased flexion of lower limbs and trunk to initiate sit-to-stand (p≤0.012; η2p = 0.41–0.84), increased peak flexion of trunk, hip and knee (p≤0.01; η2p = 0.39–0.88), increased range of motion of knee and trunk (p≤0.01; η2p = 0.45–0.85) and the duration of sit-to-stand (p≤0.05 η2p = 0.23–0.56). Children with unilateral cerebral palsy presented increased posterior pelvic tilt (p≤0.01) and decreased hip flexion of both lower limbs (p≤0.01) for all seat heights and moved their non-affected limb backward in the lowered seat (p≤0.01). Asymmetry was observed for the final and the maximal angles of the ankle in neutral and lowered seats in unilateral cerebral palsy (asymmetry index = 3.3–5.8%).InterpretationThe lowered seat height led to adaptive motor strategies in children with unilateral cerebral palsy, which should be considered in clinical practice. |
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