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Effect of Seat Surface Inclination on Postural Control During Reaching in Preterm Children With Cerebral Palsy

M Hadders-Algra, MD, PhD, is Professor of Development, Neurology, Department of Developmental Neurology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands.
JC van der Heide, PT, PhD, is Researcher, Department of Developmental Neurology, University Medical Centre Groningen, University of Groningen.
JM Fock, MD, is Pediatric Neurologist, Department of Developmental Neurology, University Medical Centre Groningen, University of Groningen.
E Stremmelaar, MD, is Pediatrician, Department of Paediatrics, University Medical Centre Groningen, University of Groningen.
LA van Eykern is Electronic Engineer, Department of Developmental Neurology, University Medical Centre Groningen, University of Groningen.
B Otten, PhD, is Professor of Neuromechanics, Center for Human Movement Sciences, University of Groningen.

m.hadders-algra{at}med.umcg.nl

Background and Purpose: Because it is debatable whether seat surface inclination improves motor function in children with cerebral palsy (CP), the effect of seat surface tilting on postural control and quality of reaching was studied.

Subjects: The subjects were 58 children with CP aged 2 to 11 years (34 with unilateral spastic CP, 24 with bilateral spastic CP).

Methods: During the task of reaching movements, surface electromyographic and kinematic data were recorded for posture and reaching with the dominant arm in 3 sitting conditions: horizontal seat surface, seat surface tilted forward 15 degrees, and seat surface tilted backward 15 degrees.

Results: In the children with unilateral spastic CP, forward tilting improved postural efficiency and quality of reaching. In the children with bilateral spastic CP, both forward and backward tilting of the seat surface was associated with more postural instability and did not affect the quality of reaching.

Discussion and Conclusion: The results suggest that, in terms of postural control and quality of reaching, children with unilateral spastic CP benefit from a forward-tilted position and children with bilateral spastic CP benefit from a horizontal sitting position.