Biomechanical Properties and Their Association With Balance and Functional Mobility in Children With Cerebral Palsy

Study Overview
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Brief Summary
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This study aimed to investigate the differences in the biomechanical properties of the dorsal trunk and lower extremity muscles of children with unilateral spastic cerebral palsy compared with their typically developing peers, and the effect of these biomechanical properties on balance and functional mobility performance.

Official Title
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Biomechanical Properties and Their Association With Balance and Functional Mobility in Children With Cerebral Palsy

Conditions
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Cerebral Palsy

Participation Criteria
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Eligibility Criteria
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Inclusion criteria for unilateral spastic cerebral palsy were: aged between 4 and 12 years, spasticity level MAS≤2, mental level sufficient to understand commands given, and ambulation without the use of an orthosis or other device. In addition, children had to be GMFCS level I or II. Exclusion criteria were: a history of spinal surgery or spinal orthosis use, uncorrected vision or hearing problems, severe epileptic seizures, lower extremity contractures, botulinum toxin A injection in the previous six months, lower extremity surgery in less than one year, use of pharmacological agents that affect muscle tone, and poor cooperation. Inclusion criteria for controls were: aged between 4 and 12 years, no neurological or orthopaedic diagnosis, no known systemic problems, normal vision and hearing, and a mental level sufficient to understand the commands given.

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| UCP<br>Children diagnosed with unilateral spastic cerebral palsy | |
| TyD<br>Typically developing children | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Pediatric Balance Scale | The Pediatric Balance Scale assesses functional balance in three categories: self-care, mobility and social function, using 14 items. Each item is scored from 0 (indicating low function) to 4 (indicating highest function), with a maximum score of 56 points. A higher score indicates better balance. | Baseline | 
| Trunk Control Measurement Scale | The TCSM was used to assess seated trunk balance and consisted of 15 items. Each item was scored from 0 to 3, with 0 indicating inability to perform the task and 3 indicating the full performance of the item. A high score indicated good trunk control | Baseline | 
| 2-Minute Walk Test | The children were asked to walk at a normal pace, without running, and the distance they walked for 2 minutes was recorded. | Baseline | 
| Timed Up and Go Test | The children were seated with their feet in full contact with the floor, in a chair with back support only, and with their hip and knee joints at 90 degrees. On the start command, they were asked to walk 3 metres to the wall at a pace they felt comfortable with and then sit back down in the chair. | Baseline | 
| Muscle tone (Hz) | The muscle tone which is a biomechanical property of the muscles evaluated with a portable hand-held myotonometer. This myotonometer (MyotonPRO - Tallinn, Estonia) is non-invasive and provides a quantitative assessment of a muscle's biomechanical properties. The MyotonPRO applies a short-intensity mechanical impulse on the skin overlying the muscle or facia. The tissue's response then generates a signal that is recorded, and an internal software program produces an acceleration graph. | Baseline | 
| Stiffness (N/m) | The stiffness which is a biomechanical property of muscles will be evaluated with a portable hand-held myotonometer. This myotonometer (MyotonPRO - Tallinn, Estonia) is non-invasive and provides a quantitative assessment of a muscle's biomechanical properties. The MyotonPRO applies a short-intensity mechanical impulse on the skin overlying the muscle or facia. The tissue's response then generates a signal that is recorded, and an internal software program produces an acceleration graph. | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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postural balance, muscle properties, mobility, paralysis, children