University of Groningen, University Medical Center Groningen, Department of Paediatrics - Division of Developmental Neurology, Groningen, The Netherlands.
University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
Res Dev Disabil. 2017 Dec;71:42-52. doi: 10.1016/j.ridd.2017.09.016. Epub 2017 Oct 5.
The effect of forward-tilting of the seat surface and foot-support in children with spastic cerebral palsy (CP) is debated.
To assess the effect of forward-tilting of the seat surface and foot-support in children with CP on kinematic head stability and reaching.
Nineteen children functioning at Gross Motor Function Classification System levels I-III participated [range 6-12y; ten unilateral spastic CP (US-CP) and nine bilateral spastic CP (BS-CP)]. Kinematic data were recorded of head sway and reaching with the dominant arm in four sitting conditions: a horizontal and a 15° forward (FW) tilted seat surface, each with and without foot-support.
Seating condition did not affect head stability during reaching, but did affect kinematic reaching quality. The major reaching parameters, i.e., the proportion of reaches with one movement unit (MU) and the size of the transport MU, were not affected by foot-support. Forward-tilting had a positive effect on these parameters in children with US-CP, whereas the horizontal condition had this effect in children with BS-CP.
A 15° forward-tilted seating and foot-support do not affect head stability. Reaching in children with US-CP profits from forward-tilting; in children with BS-CP forward-tilting worsens reaching - effects that are independent of foot-support.
座椅表面前倾和足部支撑对痉挛型脑瘫（CP）患儿的影响存在争议。
评估 CP 患儿座椅表面前倾和足部支撑对头部运动稳定性和伸手的影响。
19 名功能处于粗大运动功能分级系统 I-III 级的儿童（年龄 6-12 岁；10 名单侧痉挛型 CP（US-CP），9 名双侧痉挛型 CP（BS-CP））参与了研究。记录了 4 种坐姿下头部摆动和优势手臂伸手的运动学数据：水平位和 15°前倾（FW）座椅表面，每种坐姿都有和没有足部支撑。
座椅位置不影响伸手时的头部稳定性，但会影响伸手的运动学质量。主要的伸手参数，即具有一个运动单位（MU）的伸手比例和运输 MU 的大小，不受足部支撑的影响。在 US-CP 患儿中，FW 前倾对这些参数有积极影响，而在 BS-CP 患儿中，水平位有这种影响。
15°前倾的座椅和足部支撑不会影响头部稳定性。US-CP 患儿的伸手受益于前倾，BS-CP 患儿的前倾会使伸手恶化——这些影响与足部支撑无关。
