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Commentary on “Effect of Segmental Trunk Control on Posture and Reaching in Children With Cerebral Palsy”

Kendall, Eydie PT, PhD, PCS; Cahan, Craig PT, DPT, PCS

Pediatric Physical Therapy: October 2016 - Volume 28 - Issue 3 - p 293
doi: 10.1097/PEP.0000000000000278
CLINICAL BOTTOM LINE
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Idaho State University Pocatello, Idaho

Jumpstart Physical Therapy Coeur d'Alene, Idaho

The authors declare no conflicts of interest.

“How should I apply this information?”

The Segmental Assessment of Trunk Control (SATCo) aims to provide a standardized assessment approach for investigating segmental trunk control of children with profound movement and postural challenges. The current article ties SATCo scores to the functional sitting task of reaching. The additional evidence of how trunk control can impact reaching competence has many clinical implications. It may assist in determining appropriate reaching goals, justifying braces and other external support devices, and predicting efficacy of specific seating systems. It provides validation that posture influences hand function. This concept should be discussed more frequently with parents or school personnel who question the need for specific levels of supportive seating or the importance of working on trunk control activities. When looking at treatment outcomes, the results of this study can assist in correlating changes in trunk control with expected gains in reaching skills. As a predictive tool, the SATCo may also help to identify other factors that may impact reach.

“What should I be mindful about when applying this information?”

The SATCo does not allow for bracing, positioning devices, or adaptive strategies that children with motor impairment often employ. Future studies may be able to use the current data as a baseline to investigate how devices or strategies can compensate for lack of segmental control. This study only investigated 3 levels of trunk control, which may be easier to interpret, but may also diminish the specificity of the SATCo that includes 7 levels. Although the researchers chose appropriate indicators of reach efficiency (arm and head kinematics), there may be other confounding factors in addition to trunk control that can impact those variables. The current study does not address the effect of fatigue on trunk control and reaching skills, which could be important clinically.

Eydie Kendall, PT, PhD, PCS

Idaho State University Pocatello, Idaho

Craig Cahan, PT, DPT, PCS

Jumpstart Physical Therapy Coeur d'Alene, Idaho

Copyright © 2016 Academy of Pediatric Physical Therapy of the American Physical Therapy Association