DOI QR코드

DOI QR Code

Comparing of Lower Extremity Tactile and Trunk Position Sense in Children with Spastic Cerebral Palsy and Typically Developing Children

  • Hye-Lyeong Yun (Department of Physical Therapy, College of Life and Health, Kyungsung University, Pusan National University Yangsan Hospital) ;
  • Eun-Ju Lee (Department of Physical Therapy, College of Life and Health, Kyungsung University)
  • Received : 2024.05.17
  • Accepted : 2024.06.26
  • Published : 2024.06.30

Abstract

Purpose: To determine if there are differences in lower extremity tactile and trunk position sense processing abilities between children with spastic cerebral palsy and typically developing children. Methods: A total of 30 subjects, 15 children with spastic cerebral palsy and 15 typically developing children, aged 5-10 years, were studied. Tactile sense was measured using monofilament on the non-dominant side of a typically developing children and on the hypertonic side of a child with spastic cerebral palsy. Position sense was measured using dual digital inclinometers on the trunk. Each measurement was performed three times and the average tactile value was calculated. Data were analyzed using independent samples t-test to determine group differences. Results: Children with spastic cerebral palsy perceived larger diameter filaments in the lower extremity tactile test than typically developing children and trunk position sense tests showed larger postural reproduction errors, confirming that children with spastic cerebral palsy have deficits in somatosensory processing (p<0.05). Conclusion: We suggest that to improve the physical functioning of children with spastic cerebral palsy, intervention programs should not only consider motor but also sensory processing abilities.

Keywords

References

  1. Bax M, Goldstein M, Rosenbaum P et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005;47(8):571-6.
  2. Blumenstein T, Alves-Pinto A, Turova V et al. Sensory feedback training for improvement of finger perception in cerebral palsy. Rehabil Res Pract. 2015;1:1-7.
  3. Schmidt RA, Lee TD, Winstein C et al. Motor control and learning: a behavioral emphasis. 5th ed. USA, Human Kinetics, 2011:135-6.
  4. Cauller L. Layer I of primary sensory neocortex: where top-down converges upon bottom-up. Behav Brain Res. 1995;71(1-2):163-70.
  5. Wingert JR, Burton H, Sinclair RJ et al. Tactile sensory abilities in cerebral palsy: deficits in roughness and object discrimination. Dev Med Child Neurol. 2008;50(11):832-8.
  6. Cooper J, Majnemer A, Rosenblatt B et al. The determination of sensory deficits in children with hemiplegic cerebral palsy. J Child Neurol. 1995;10(4):300-9.
  7. Bleyenheuft Y, Gordon AM. Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: a systematic review. Res Dev Disabil. 2013;34(9):3014-28.
  8. Trivedi R, Agarwal S, Shah V et al. Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy. Neuroradilolgy. 2010;52(8):759-65.
  9. Brun C, Traverse E, Granger E et al. Somatosensory deficits and neural correlates in cerebral palsy: a scoping review. Dev Med Child Neurol. 2021;63(12):1382-93.
  10. Coq J, Strata F, Russier M et al. Impact of neonatal asphyxia and hind extremity immobilization on musculoskeletal tissues and S1 map organization: implications for cerebral palsy. Exp Neurol. 2008;210(1):95-108.
  11. Liao HF, Hwang AW. Relations of balance function and gross motor ability for children with cerebral palsy. Percept Mot Skills. 2003;96(3 Pt 2):1173-84.
  12. Woollacott MH, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance? Neural Plast. 2005;12(2-3):211-9.
  13. Park MO. The relationship between sensory processing abilities and gross and fine motor capabilities of children with cerebral palsy. J Korean Soc Phys Med. 2017;12(2):67-74.
  14. Zarkou A, Lee SCK, Prosser L et al. Foot and ankle somatosensory deficits in children with cerebral palsy: a pilot study. J Pediatr Rehabil Med. 2021;14(2):247-55.
  15. Auld ML, Boyd R, Moseley GL et al. Tactile function in children with unilateral cerebral palsy compared to typically developing children. Disabil Rehabil. 2012;34(17):1488-94.
  16. Shamsoddini AR, Hollisaz MT. Effect of sensory integration therapy on gross motor function in children with cerebral palsy. Iran J Child Neurol. 2009;3(2):43-8.
  17. Bell-Krotoski J, Tomancik E. The repeatability of testing with semmes-weinstein monofilaments. J Hand Surg Am. 1987;12(1):155-61.
  18. O'Sullivan PB, Burnett A, Floyd AN et al. Lumbar repositioning deficit in a specific low back pain population. J Spine. 2003;28(10):1074-9.
  19. Cascio CJ. Somatosensory processing in neurodevelopmental disorders. J Neurodev Disord. 2010;2(2):62-9.
  20. Maitre NL, Barnett ZP, Key APF. Novel assessment of cortical response to somatosensory stimuli in children with hemiparetic cerebral palsy. J Child Neurol. 2012;27(10):1276-83.
  21. Wingert JR, Burton H, Sinclair RJ et al. Joint-position sense and kinesthesia in cerebral palsy. Arch Phys Med Rehabil. 2009;90(3):447-53.
  22. Lieber RL, Friden J. Spasticity causes a fundamental rearrangement of muscle-joint interaction. Muscle Nerve. 2002;25(2):265-70.
  23. Donker SF, Ledebt A, Roerdink M et al. Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children. Exp Brain Res. 2008;184(3):363-70.
  24. Morais FD, Freitas JC, Viana FP et al. Correlation between neurofunctional profile and sensory-motor skills of children with cerebral palsy. J Hum Growth Dev. 2012;22(2):226-32.
  25. Lesny I, Stehlik A, Tomasek J et al. Sensory disorders in cerebral palsy: two-point discrimination. Dev Med Child Neurol. 1993;35(5):402-5.
  26. Fowler EG, Staudt LA, Greenberg MB. Lower-extremity selective voluntary motor control in patients with spastic cerebral palsy: increased distal motor impairment. Dev Med Child Neurol. 2010;52(3):264-9.
  27. Tecklin JS. Pediatric physical therapy. 4th ed. USA, Lippincott Williams & Wilkins, 2008:183-4.
  28. Sanger TD, Kukke SN. Abnormalities of tactile sensory function in children with dystonic and diplegic cerebral palsy. J Child Neurol. 2007;22(3):289-93.
  29. Monica S, Nayak A, Joshua AM et al. Relationship between trunk position sense and trunk control in children with spastic cerebral palsy: a cross-sectional study. Rahabil Res Pract. 2021;2021:6.
  30. Clayton K, Fleming JM, Copley J. Behavioral responses to tactile stimuli in children with cerebral palsy. Phys Occup Ther Pediatr. 2003;23(1):43-62.
  31. Schaaf RC, Miller LJ. Occupational therapy using a sensory integrative approach for children with developmental disabilities. Ment Retard Dev Disabil Res Rev. 2005;11(2):143-8.