Abstract
Sensory dysfunction is prevalent in cerebral palsy (CP). Evidence suggests that sensory deficits can contribute to manual ability impairments in children with CP, yet it is still unclear how they contribute to balance and motor performance. Therefore, the objective of this study was to investigate the relationship between lower extremity (LE) somatosensation and functional performance in children with CP. Ten participants with spastic diplegia (Gross Motor Function Classification Scale: I-III) and who were able to stand independently completed the study. Threshold of light touch pressure, two-point discriminatory ability of the plantar side of the foot, duration of cutaneous vibration sensation, and error in the joint position sense of the ankle were assessed to quantify somatosensory function. The balance was tested by the Balance Evaluation System Test (BESTest) and postural sway measures during a standing task. Motor performance was evaluated by using a battery of clinical assessments: (1) Gross Motor Function Measure (GMFM-66-IS) to test gross motor ability; (2) spatiotemporal gait characteristics (velocity, step length) to evaluate walking ability; (3) Timed Up and Go (TUG) and 6 Min Walk (6MWT) tests to assess functional mobility; and (4) an isokinetic dynamometer was used to test the Maximum Volitional Isometric Contraction (MVIC) of the plantar flexor muscles. The results showed that the light touch pressure measure was strongly associated only with the 6MWT. Vibration and two-point discrimination were strongly related to balance performance. Further, the vibration sensation of the first metatarsal head demonstrated a significantly strong relationship with motor performance as measured by GMFM-66-IS, spatiotemporal gait parameters, TUG, and ankle plantar flexors strength test. The joint position sense of the ankle was only related to one subdomain of the BESTest (Postural Responses). This study provides preliminary evidence that LE sensory deficits can possibly contribute to the pronounced balance and motor impairments in CP. The findings emphasize the importance of developing a thorough LE sensory test battery that can guide traditional treatment protocols toward a more holistic therapeutic approach by combining both motor and sensory rehabilitative strategies to improve motor function in CP.
Highlights
Sensory inputs are crucial for the developing nervous system because they allow for the proper synaptic organization of the brain
Our results demonstrated that foot and ankle somatosensation is strongly related to standing balance and motor performance; supporting the notion that plantar cutaneous and ankle proprioceptive deficits may contribute to the postural control and mobility impairments in this population
Our results showed that lower extremity (LE) somatosensory function is strongly related to balance performance in cerebral palsy (CP) and, impairments in the plantar cutaneous and ankle proprioceptive function may partially contribute to balance deficits
Summary
Sensory inputs are crucial for the developing nervous system because they allow for the proper synaptic organization of the brain. Sensory deficits in CP have been primarily attributed to the injury of the immature brain and, secondarily, stem as a result of limited learning experience (Clayton et al, 2003; Rosenbaum et al, 2007) because motor impairments may not allow environmental exploration; a crucial element in development. Abnormal sensorimotor oscillatory activity during a knee extension task has shown that children with CP may have anticipatory feedforward control deficits, as their limited environmental exploration early in life does not allow them to develop appropriate internal models for a successful motor response (Kurz et al, 2014a). The aforementioned findings suggest that sensory processing deficits associated with this pathology may lead to impaired motor planning and diminished postural control
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
