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Dissertation
Evaluation of the standing balance of children with cerebral palsy and the tools for assessment
Doctor of Philosophy (Ph.D.), Allegheny University of the Health Sciences
May 1997
DOI:
https://doi.org/10.17918/00002055
Abstract
Children with cerebral palsy frequently receive physical therapy to remediate balance deficits. Evaluation of the impairments associated with poor balance could facilitate more effective treatment programs. This study was designed to evaluate the standing balance of children with cerebral palsy using a systems approach to identify the impairments associated with poor balance. Additionally, this study looked at several psychometric properties of the instruments used for balance assessment. Thirty five children between the ages of 6 and 14 years of age with spastic cerebral palsy were evaluated using the Pediatric Clinical Test of Sensory Interaction (P-CTSIB), the Timed Up and Go (TUG), the Bruininks-Oseretsky Test of Motor Proficiency running speed and agility subtest (RUN), the Pediatric Evaluation Of Disability Index (PEDI), goniometry and hand-held dynamometry. The results indicated that children with hemiplegia scored significantly better on the P-CTSIB than children with either diplegia or quadriplegia. The P-CTSIB detected a deficit in the ability of children with diplegia to maintain standing balance when inaccurate somatosensory information was presented. This deficit was not present in the children with hemiplegia. During the testing the children were noted to primarily use an ankle strategy to maintain their balance, but also utilized a crouching strategy. The P-CTSIB was shown to have a moderate correlation to the TUG, RUN and PEDI mobility and self-care functional skill subtest. Blocked, hierarchical multiple regression analysis revealed that force production explained 31% of the variance in P-CTSIB scores in this sample while range of motion explained an additional 13%. The total variance explained by these variables was, therefore, 54%. Results of this study would suggest that impairment level testing may allow the development of more effective individualized treatment programs to remediate balance deficits. Testing should include evaluation of sensory processing abilities, force production and range of motion. The large amount of variance in P-CTSIB scores that was explained by the strength and range of motion variables suggests that intervention to remediate these impairments should be considered as part of a balance treatment program. This study also supported the use of the P-CTSIB as an evaluative measure of a child's balance abilities.
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Details
- Title
- Evaluation of the standing balance of children with cerebral palsy and the tools for assessment
- Creators
- Linda Pax Lowes
- Contributors
- Sarah L. Westcott (Advisor) - Drexel University, Allegheny University of the Health Sciences (1996-1998)
- Awarding Institution
- Allegheny University of the Health Sciences
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Allegheny University of the Health Sciences; Philadelphia, Pennsylvania
- Number of pages
- ix, 134 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Allegheny University of the Health Sciences (1996-1998); School of Health Professions (1996-1998); Physical Therapy
- Other Identifier
- 991021889010604721