DOI QR코드

DOI QR Code

The Correlation between Physical Function and Lower Limb Tactile Sense in Children with Spastic Cerebral Palsy

경직형 뇌성마비 아동의 신체기능과 하지 촉각의 상관관계 연구

  • Hye-Lyeong Yun (Department of Physical Therapy, Kyungsung University) ;
  • Na-Yeon YE (Department of Physical Therapy, Kyungsung University) ;
  • Eun-Ju Lee (Department of Physical Therapy, Kyungsung University)
  • 윤혜령 (경성대학교 물리치료학과) ;
  • 예나연 (경성대학교 물리치료학과) ;
  • 이은주 (경성대학교 물리치료학과)
  • Received : 2023.07.19
  • Accepted : 2023.08.13
  • Published : 2023.08.31

Abstract

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

Keywords

References

  1. Auld ML, Boyd R, Moseley GL, et al. Tactile function in children with unilateral cerebral palsy compared to typically developing children. Disability and Rehabilitation. 2012;34(17):1488-1494. https://doi.org/10.3109/09638288.2011.650314
  2. Ayres AJ. Sensory integration and praxis tests (SIPT). Los Angeles: Western Psychological Services (WPS). 1996.
  3. Blanche E, Burke JP. Combining neurodevelopmental and sensory integration approaches in the treatment of the neurologically impaired child. part 2. Sensory Integration Quarterly. 1991;19(1):1-2.
  4. Blanche EI, Botticelli TM, Hallway MK, et al. Combining neuro-developmental treatment and sensory integration principles: An approach to pediatric therapy. San Antonio TX: Therapy Skills Builders. 1998.
  5. Bleyenheuft Y, Gordon AM. Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: A systematic review. Research in Developmental Disabilities. 2013;34(9):3014-3028. https://doi.org/10.1016/j.ridd.2013.05.047
  6. Bloem B, Allum J, Carpenter M, et al. Is lower leg proprioception essential for triggering human automatic postural responses? Experimental Brain Research. 2000;130(3):375-391. https://doi.org/10.1007/s002219900259
  7. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy & Rehabilitation Journal. 1987;67(2):206-207.
  8. Burton H, Dixit S, Litkowski P, et al. Functional connectivity for somatosensory and motor cortex in spastic diplegia. Somatosensory & Motor Research. 2009;26(4):90-104. https://doi.org/10.3109/08990220903335742
  9. Cascio CJ. Somatosensory processing in neurodevelopmental disorders. Journal of Neurodevelopmental Disorders. 2010;2:62-69. https://doi.org/10.1007/s11689-010-9046-3
  10. Clayton K, Fleming JM, Copley J. Behavioral responses to tactile stimuli in children with cerebral palsy. Physical & Occupational Therapy in Pediatrics. 2003;23(1):43-62. https://doi.org/10.1080/J006v23n01_04
  11. Dannenbaum RM, Dykes RW. Sensory loss in the hand after sensory stroke: Therapeutic rationale. Archives of Physical Medicine and Rehabilitation. 1988;69(10):833-839.
  12. Donker SF, Ledebt A, Roerdink M, et al. Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children. Experimental Brain Research. 2008;184:363-370. https://doi.org/10.1007/s00221-007-1105-y
  13. Fitzpatrick R, Rogers DK, McCloskey DI. Stable human standing with lower-limb muscle afferents providing the only sensory input. The Journal of Physiology. 1994;480(2):395-403. https://doi.org/10.1113/jphysiol.1994.sp020369
  14. Fowler EG, Staudt LA, Greenberg MB. Lower-extremity selective voluntary motor control in patients with spastic cerebral palsy: Increased distal motor impairment. Developmental Medicine & Child Neurology. 2010;52(3):264-269. https://doi.org/10.1111/j.1469-8749.2009.03586.x
  15. Hohne A, Ali S, Stark C, et al. Reduced plantar cutaneous sensation modifies gait dynamics, lower-limb kinematics and muscle activity during walking. European Journal of Applied Physiology. 2012;112:3829-3838. https://doi.org/10.1007/s00421-012-2364-2
  16. Hoon AH, Lawrie WT, Melhem ER, et al. Diffusion tensor imaging of periventricular leukomalacia shows affected sensory cortex white matter pathways. Neurology. 2002;59(5):752-756. https://doi.org/10.1212/WNL.59.5.752
  17. Kavounoudias A, Roll R, Roll J. The plantar sole is a 'dynamometric map'for human balance control. Neuroreport. 1998;9(14):3247-3252. https://doi.org/10.1097/00001756-199810050-00021
  18. Kennedy PM, Inglis JT. Distribution and behaviour of glabrous cutaneous receptors in the human foot sole. The Journal of Physiology. 2002;538(3):995-1002.
  19. Kurz MJ, Becker KM, Heinrichs-Graham E, et al. Neurophysiological abnormalities in the sensorimotor cortices during the motor planning and movement execution stages of children with cerebral palsy. Developmental Medicine & Child Neurology. 2014;56(11):1072-1077. https://doi.org/10.1111/dmcn.12513
  20. Kurz MJ, Heinrichs-Graham E, Becker KM, et al. The magnitude of the somatosensory cortical activity is related to the mobility and strength impairments seen in children with cerebral palsy. Journal of Neurophysiology. 2015;113(9):3143-3150. https://doi.org/10.1152/jn.00602.2014
  21. Lundy-Ekman L. Neuroscience-e-book: fundamentals for rehabilitation. Elsevier Health Sciences. 2012. 
  22. McLaughlin JF, Felix SD, Nowbar S, et al. Lower extremity sensory function in children with cerebral palsy. Pediatric Rehabilitation. 2005;8(1):45-52. https://doi.org/10.1080/13638490400011181
  23. Palisano RJ, Hanna SE, Rosenbaum PL, et al. Validation of a model of gross motor function for children with cerebral palsy. Physical therapy. 2000;80(10):974-985. https://doi.org/10.1093/ptj/80.10.974
  24. Papadelis C, Ahtam B, Nazarova M, et al. Cortical somatosensory reorganization in children with spastic cerebral palsy: A multimodal neuroimaging study. Frontiers in Human Neuroscience. 2014;8:725.
  25. Papadelis C, Butler EE, Rubenstein M, et al. Reorganization of the somatosensory cortex in hemiplegic cerebral palsy associated with impaired sensory tracts. NeuroImage: Clinical. 2018;17:198-212. https://doi.org/10.1016/j.nicl.2017.10.021
  26. Riquelme I, Padron I, Cifre I, et al. Differences in somatosensory processing due to dominant hemispheric motor impairment in cerebral palsy. BMC Neuroscience. 2014;15:1-9. https://doi.org/10.1186/1471-2202-15-1
  27. Rosenbaum P, Paneth N, Leviton A, et al. A report: The definition and classification of cerebral palsy april 2006. Developmental Medicine & Child Neurol Suppl, 109(suppl 109). 2007;8-14.
  28. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction on balance: Suggestion from the field. Physical Therapy. 1986;66(10):1548-1550. https://doi.org/10.1093/ptj/66.10.1548
  29. Sugden D, Keogh J. Problems in movement skill development. University of South Caroliner Press, Columbia. 1990.
  30. Umansky, R. The hand sock, an artificial handicap to prehension in infancy, and its relation to clinical disuse phenomena. Pediatrics. 1973;52(4):546-554. https://doi.org/10.1542/peds.52.4.546
  31. van Brakel WH, Khawas IB, Gurung KS, et al. Intra-and Inter-Tester Reliability of Sensibility Testing in Leprosy'. INTERNATIONAL. JOURNAL OF LEPROSY. 1996;64(3):287-298.
  32. van Roon D, Steenbergen B, Meulenbroek RG. Trunk use and co-contraction in cerebral palsy as regulatory mechanisms for accuracy control. Neuropsychologia. 2005;43(4):497-508. https://doi.org/10.1016/j.neuropsychologia.2004.07.014
  33. Verheyden G, Nieuwboer A, Mertin J, et al. The trunk impairment scale: a new tool to measure motor impairment of the trunk after stroke. Clinical Rehabilitation. 2004;18(3):326-334. https://doi.org/10.1191/0269215504cr733oa
  34. Wingert JR, Burton, H, Sinclair RJ, et al. Tactile sensory abilities in cerebral palsy: Deficits in roughness and object discrimination. Developmental Medicine & Child Neurology. 2008;50(11):832-838. https://doi.org/10.1111/j.1469-8749.2008.03105.x
  35. Wingert JR, Burton H, Sinclair RJ, et al. Joint-position sense and kinesthesia in cerebral palsy. Archives of Physical Medicine and Rehabilitation. 2009;90(3):447-453. https://doi.org/10.1016/j.apmr.2008.08.217
  36. Yun HL, Lee EJ. Effects of Wole Body Vibration Training on Transverse Abdominis Muscle Thickness and Sitting Balance in Spastic Cerebral Palsy. Journal of Korean Physical Therapy Science. 2023;30(1):72-84.
  37. Zarkou A, Lee SC, Prosser LA, et al. Foot and ankle somatosensory deficits affect balance and motor function in children with cerebral palsy. Frontiers in Human Neuroscience.2020;14:45.
  38. Zarkou A, Lee SC, Prosser L, et al. Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study. Journal of Pediatric Rehabilitation Medicine. 2021;14(2):247-255. https://doi.org/10.3233/PRM-190643