Hemiplegic Cerebral Palsy Patients Have Postural Stability Issues

Children with hemiplegic cerebral palsy (CP) have postural stability problems, either when standing or in movement, according to a recent study  published in the Journal of Physical Therapy Science.

Postural stability is the ability to maintain the body position without changing the base of support. It requires the requires the complex integration of the central nervous system (brain communication) and the musculo-skeletal system (body movement), but because the disease affects both systems, postural stability occurs.

The most common types of CP are hemiplegia, in which one arm and one leg on the same side of the body are affected, and diplegia, or paraplegia, where both legs are affected. Since children with hemiplegic CP have better motor function, most rehabilitation studies have focused on patients with diplegic CP.

For the study “Evaluation of postural stability in children with hemiplegic cerebral palsy,” Turkish researchers tested 33 children, aged 5-14 years, with mild hemiplegic CP; 19 with the right side of the body affected, and 18 with the problem present in the left side. The team compared the children’s active and passive postural stability with that of children without the condition of the same age and gender.

The Modified Clinical Test for Sensory Interaction on Balance (mCTSIB), a test that assesses whether a patient is able to maintain their position for 30 seconds, with eyes open or closed, was used to evaluate sensory dysfunction and static postural stability. Dynamic stability was assessed by sit to stand, and step and quick turn tests.

Results demonstrated that hemiplegic CP patients inclined to one side at faster velocities than children without CP, both with eyes open or closed. They also took significantly longer times to transfer their weight in the sit to stand test than the control children. Additionally, hemiplegic CP children were found to turn slower than the other children in the quick turn test.

Such findings demonstrated that hemiplegic CP children have both their static and dynamic postural stability affected, suggesting that more rehabilitation interventions are needed to improve function for daily activities.