A Descriptive Study of Lower Limb Torsional Kinematic Profiles in Children With Spastic Diplegia (original) (raw)

2015, Journal of Pediatric Orthopaedics

Sit-to-stand movement changes in preschool-aged children with spastic diplegia following one neurodevelopmental treatment sessiona pilot Yonetsu R1, Iwata A, Surya J, Unase K, Shimizu J. Purpose: This study was designed to provide a better understanding of how a single neurodevelopmental treatment (NDT) session affects sit-to-stand (STS) movements in children with cerebral palsy (CP). Methods: Eight children with spastic diplegia and five typically developing children, aged 4-6 years, participated in this study. The CP participants performed STS movements immediately before and after a 40-min NDT session. Using a threedimensional, four-camera analysis system, angular movements involving the hip, knee and ankle joints of the participants were obtained. Results: During forward tilt of the trunk, the maximum and final angles after the NDT session significantly decreased compared with those before the session (p < 0.05, p < 0.01). Moreover, the final hip flexion after the session also significantly decreased compared with that before the session (p < 0.01). On the other hand, the initial, maximum and final ankle dorsiflexion angles after the session were significantly greater (p < 0.05, p < 0.01 and p < 0.05, respectively) than before the session. Conclusions: These findings suggest that a single NDT session enables children with CP to stand from a seated position without using some atypical movement patterns. Implications for Rehabilitation Preschool-aged children with spastic diplegia, with limited ability to independently transfer from a sitting position, and dependent on a wheelchair for mobility experience obstacles to enhanced activities of daily life and social participation. A single neurodevelopmental treatment session would enable children with spastic diplegia to perform sit-to-stand movements more efficiently, with selective muscle control. Understanding how a single neurodevelopmental treatment session affects sit-to-stand movements in children with spastic diplegia is invaluable for therapists planning more efficient therapeutic programs and may enable children with spastic diplegia to develop improved mobility.