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Postural Orientation During Standing in Children With Bilateral Cerebral Palsy

Lidbeck, Cecilia M. PT, MSc; Gutierrez-Farewik, Elena M. PhD; Broström, Eva PT, PhD; Bartonek, Åsa PT, PhD

doi: 10.1097/PEP.0000000000000025
Research Article

Purpose: To investigate postural orientation and maintenance of joint position during standing in children with bilateral spastic cerebral palsy (BSCP).

Methods: Standing was examined with 3-D motion analysis in 26 children with BSCP, and 19 children typically developing (TD). Two groups of children with cerebral palsy (CP) were analyzed: 15 who were able to maintain standing without support and 11 who needed support.

Results: Children with CP stood with more flexion than children TD. In the CP groups, children standing without support stood more asymmetrically with less hip and knee flexion and less movement than those who required support.

Conclusion: Children with CP had varying abilities to stand and maintain standing posture with or without support. Both CP groups stood with more flexion than their potential passive joint angle, more obvious in children requiring support. Investigations on how muscle strength and spatial perception influence posture remains to be explored.

The varying abilities of children with CP to stand and maintain standing posture with or without support are described. All stood with greater flexion than their passive extension range would allow, and this was more evident in those requiring support to stand.

Department of Women's and Children's Health (Ms Lidbeck and Drs Gutierrez-Farewik, Broström, and Bartonek) Karolinska Institutet, Stockholm, Sweden; KTH Mechanics (Dr Gutierrez-Farewik), Royal Institute of Technology, Stockholm, Sweden.

Correspondence: Cecilia M. Lidbeck, PT, MSc, Motoriklab Q2:07, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden (

Grant support: This study was supported by The Frimurare Barnhuset Foundation and Promobilia Foundation in Stockholm, Sweden.

The authors declare no conflict of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.