Effects of Physical Therapy on Postural Control in Children with Cerebral Palsy.

Jonsdottir, Johanna MS, PT; Fetters, Linda PhD, PT; Kluzik, Joann MS, PT
Pediatric Physical Therapy: Summer 1997
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Posture and balance are integral parts of voluntary movements. The purpose of this study was to investigate the effect of two different treatment interventions, neurodevelopmental treatment (NOT) and practice, on postural control of children with cerebral palsy during a reaching task. The subjects were eight children 10 to 15 years of age with cerebral palsy. They were treated daily for five days with NDT and five days with practice. Posture was assessed using kinematic analysis and videography. Total displacement of the head (TDH) and shoulder (TDS) during the reaching movement was used to assess postural displacement before and after treatment. In addition, postural alignment was evaluated and scored from a videotape using a modified version of the Posture Assessment Scale (PAS). No significant differences were found for either TDH or TDS for either of the treatment conditions. There were no significant differences in modified PAS scores for either treatment. However, when one subject's extreme data values were eliminated from the pooled data for the modified PAS, there was a significant improvement in postural alignment after NDT but not after practice. NDT seemed more effective than practice for improvement of postural alignment during a reaching task. Postural alignment rather than displacement of the head and shoulder in space may be more amenable to NDT and a more relevant variable for postural assessment.

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