1. Asymmetry in children with unilateral cerebral palsy during sit-to-stand movement: Cross-sectional, repeated-measures and comparative study.
- Author
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Dos Santos AN, Pena GM, Guilherme EM, and Rocha NACF
- Subjects
- Ankle Joint physiopathology, Biomechanical Phenomena, Child, Cross-Sectional Studies, Female, Humans, Kinetics, Knee Joint physiopathology, Leg physiopathology, Male, Range of Motion, Articular, Reproducibility of Results, Sitting Position, Standing Position, Cerebral Palsy physiopathology, Movement, Torso
- Abstract
Background: We aimed to compare motor strategies adopted by children with unilateral Cerebral Palsy and typically developing children during the performance of sit-to-stand., Methods: Eleven children with unilateral cerebral palsy and 20 typically developing children were evaluated. Kinematic and kinetic analysis of the sit-to-stand movement was performed. Three seat heights were evaluated: neutral (90° of hip-knee-ankle flexion), elevated to 120% of the neutral height, and lowered to 80% of the neutral height. As outcome variables, we considered sit-to-stand duration (temporal); initial, final and maximal sagittal angles and range of motion of trunk, pelvis, hip, knee, and ankle (kinematics); the peak of vertical ground reaction force (kinetics), and asymmetric index. Effect size is represented by η
2 p., Findings: We found that for the lowered seat, all groups presented increased flexion of lower limbs and trunk to initiate sit-to-stand (p≤0.012; η2 p = 0.41-0.84), increased peak flexion of trunk, hip and knee (p≤0.01; η2 p = 0.39-0.88), increased range of motion of knee and trunk (p≤0.01; η2 p = 0.45-0.85) and the duration of sit-to-stand (p≤0.05 η2 p = 0.23-0.56). Children with unilateral cerebral palsy presented increased posterior pelvic tilt (p≤0.01) and decreased hip flexion of both lower limbs (p≤0.01) for all seat heights and moved their non-affected limb backward in the lowered seat (p≤0.01). Asymmetry was observed for the final and the maximal angles of the ankle in neutral and lowered seats in unilateral cerebral palsy (asymmetry index = 3.3-5.8%)., Interpretation: The lowered seat height led to adaptive motor strategies in children with unilateral cerebral palsy, which should be considered in clinical practice., Competing Interests: Declaration of competing interest This study was not funded. The authors declare that they have no conflict of interest, other than any noted in the covering letter to the editor., (Copyright © 2019 Elsevier Ltd. All rights reserved.)- Published
- 2020
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