Hip spasticity and strength from 44 children with cerebral palsy (CP) and 44 children with able bodies (AB) were compared. For spasticity, a KinCom dynamometer abducted the passive hip at 4 different speeds and recorded the resistive adductor torques. Work values for the torque-angle data were calculated at each speed. Linear regression derived the slope for the line of best fit for the work-velocity data to determine the spasticity measure. For strength, the KinCom rotated the hip from maximum adduction to maximum abduction at a speed of 10°/s while the child performed a maximum abduction concentric contraction. Tests were reversed to record maximum adduction. Maximum torques and work by the abductors and adductors were calculated. Spasticity in the adductors for the CP group was significantly greater than values recorded for the AB group. All strength measures were significantly less than the AB group. Results provide objective information, quantifying hip spasticity and strength in children with CP.
Jack R. Engsberg, Sandy A. Ross, Kevin W. Hollander and T.S. Park
Saichon Kloyiam, Sarah Breen, Philip Jakeman, Joe Conway and Yeshayahu Hutzler
The purpose of this study was to describe running economy, soccer specific endurance, and selected kinematic running criteria in soccer players with cerebral palsy (SPCP) and to compare them with values of position-matched players without CP. Fourteen international, male soccer players with cerebral palsy completed the “Yo-Yo” intermittent recovery run level 1 (IRL-1) test to assess soccer-specific endurance and a submaximal running test on a treadmill to determine running economy. The mean IRL-1 distance covered by the SPCP of the Irish CP team was found to be 43–50% below the mean distance attained by position-matched soccer players without disability, while running economy was found to be within the range of that reported for able-bodied athletes. No relationship could be found between the level of CP-ISRA classification and soccer-specific endurance or running economy in this group of elite level SPCP. Though small in number, these data support a further examination of the relationship between CP classification and sport-specific performance.
The effect of amplitude incongruence (small circles–large circles) and form incongruence (circles–lines) on the performance of the affected and non-affected arm was examined in 12 children with hemiplegic cerebral palsy in bimanual rhythmic drawing tasks. Amplitude and form incongruence are assumed to be associated with aspects of movement execution and movement planning, respectively. The following questions were addressed: Does amplitude or form incongruence in bimanual coordination result in: (a) accommodation of the affected or non-affected arm, or both, (b) an increase of temporal variability of drawing movements of the affected or non-affected arm, and (c) a decrease of bimanual coordination stability? Form incongruence resulted in accommodation of both affected and non-affected arm in a similar way found in non-disabled participants. Despite this accommodation, the temporal variability of both affected and non-affected arm was increased, and coordination stability decreased, because the spatial trajectories of affected and non-affected arm were still rather dissimilar. Amplitude incongruence resulted in accommodation of either the affected arm (large circles required) or non-affected arm (small circles required), and in an increase or decrease of temporal variability of the affected arm, depending on the degree of spatial similarity of the trajectories of affected and non-affected arm. These findings suggest that in children with hemiplegic cerebral palsy aspects of movement execution, but not aspects of movement planning are affected by the “hemiplegic” condition.
Shawn Russell, Bradford Bennett, Pradip Sheth and Mark Abel
This paper describes a method to characterize gait pathologies like cerebral palsy using work, energy, and angular momentum. For a group of 24 children, 16 with spastic diplegic cerebral palsy and 8 typically developed, kinematic data were collected at the subjects self selected comfortable walking speed. From the kinematics, the work—internal, external, and whole body; energy—rotational and relative linear; and the angular momentum were calculated. Our findings suggest that internal work represents 53% and 40% respectively of the whole body work in gait for typically developed children and children with cerebral palsy. Analysis of the angular momentum of the whole body, and other subgroupings of body segments, revealed a relationship between increased angular momentum and increased internal work. This relationship allows one to use angular momentum to assist in determining the kinetics and kinematics of gait which contribute to increased internal work. Thus offering insight to interventions which can be applied to increase the efficiency of bipedal locomotion, by reducing internal work which has no direct contribution to center of mass motion, in both normal and pathologic populations.
Edwin Van Thiel and Bert Steenbergen
In this study, we examined the degree and timing of shoulder displacements during hitting, reaching, and grasping movements performed by young adults with hemiparetic cerebral palsy. The participants performed unimanual and bimanual arm movements towards targets and objects of different sizes. On the basis of the assumption that shoulder displacement due to trunk translation and rotation is a successful, adaptive reaction to reduced joint mobility in the affected arm, the fluency of hand displacements was expected to remain invariant under variations of shoulder displacement as is also the case in healthy participants. The results point in this direction. With respect to the timing of shoulder displacement, prior research suggested that hemiparetic movements can be characterized by inconsistent motion-timing patterns—that is, the timing of shoulder and hand-displacement onsets varied between trials. Therefore, the within-subject variability of the movement-onset asynchrony between hand and ipsilateral shoulder displacement was expected to be larger on the impaired side than on the unimpaired side. This prediction was not confirmed. which challenges these earlier conclusions. Additionally. we also examined the peak-velocity asynchrony of the hand and shoulder. Contrary to the onset asynchrony, the peak asynchrony varied between the hitting and reaching task and between the hitting and grasping task. For the reaching and grasping tasks, there were also significant differences between hands. Again, variability of the (peak-velocity) asynchrony was not significantly increased when comparing the impaired hand with the unimpaired hand. The results suggests that the hemiparetic participants were capable of flexibly recruiting and sequencing the various degrees of freedom of their impaired side required for successful task completion, albeit in different magnitudes and sequenced differently.
Max G. Feltham, Annick Ledebt, Simon J. Bennett, Frederik J.A. Deconinck, Martine H.G. Verheul and Geert J.P. Savelsbergh
The study examined symmetrical bimanual coordination of children with spastic hemiparetic cerebral palsy (SHCP) and a typically developing (TD) control group under conditions of visual feedback created by placing a glass screen, opaque screen or a mirror (“mirror box”) between the arms. The “mirror box” creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. Children with SHCP exhibited a similar mean coordination pattern as the TD control group, but had greater movement variability between the arms. Furthermore, movement variability in children with SHCP was significantly greater in the screen condition compared with the glass and mirror condition, which were similar to each other. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to central and peripheral mechanisms.
Raúl Reina, Aitor Iturricastillo, Rafael Sabido, Maria Campayo-Piernas and Javier Yanci
degree of horizontal strength, 3 , 5 recent research has also focused interest on studying horizontal jump (HJ) capacity in football players. 3 , 5 , 6 Cerebral palsy (CP) is a nonprogressive upper motor neuron disorder caused by lesions in the motor cortex, cerebellum, and basal ganglia before, during
Simona Bar-Haim, Ronit Aviram, Anat Shkedy Rabani, Akram Amro, Ibtisam Nammourah, Muhammed Al-Jarrah, Yoav Raanan, Jack A. Loeppky and Netta Harries
low energy expenditure (≤1.5 metabolic equivalents), which includes sitting and reclining posture ( 32 ). Adolescents and young adults with cerebral palsy (CP) who are ambulatory are less physically active and spend more time sedentary than able-bodied individuals, placing them at increased risk for
Kenneth Aggerholm and Kristian Møller Moltke Martiny
these recent developments in the field. We present a study of a winter sports camp for young people with cerebral palsy (CP). CP is defined as a group of disorders affecting the development of postural and motor control and occurring as a result of a nonprogressive lesion in the developing central
Jack R. Engsberg, Richard E. A. Van Emmerik, Sandy A. Ross and David R. Collins
This investigation developed a measure of motor control at the ankle for persons with CP using relative phase. Twenty-nine subjects, 14 with spastic diplegia cerebral palsy (CP group) and 15 without disability (WD group) were tested once. Video data were collected as a seated subject performed four full range of ankle plantar and dorsiflexion movement tasks (right ankle, left ankle, ankles in-phase with each other, and ankles antiphase to each other) at four different frequencies (self-paced, 0.5, 0.75, 1.0 Hz). The relative phase measure was able to discern the differences between the two groups of children. The CP group had poorer motor control than the WD group, based upon the measure. Both groups had more difficulty performing the antiphase than the in-phase movements. The investigation adds to the body of knowledge in that the concept of relative phase was used as a measure of motor control at the ankle in persons with CP. Results indicated that the measure was adequately sensitive to quantify differences between a group with CP and a group without disability. Clinically the measure could eventually be used as both an assessment and outcome tool.