Deliberately Light Interpersonal Contact Affects the Control of Head Stability During Walking in Children and Adolescents With Cerebral Palsy

Published:February 28, 2017DOI:https://doi.org/10.1016/j.apmr.2017.01.026

      Highlights

      • Apex interpersonal touch (IPT) alters locomotor control of head sway in cerebral palsy (CP).
      • Trunk IPT acts in opposition to head IPT in CP.
      • IPT affects typically developed individuals differently than individuals with CP.

      Abstract

      Objective

      To evaluate the potential of deliberately light interpersonal touch (IPT) for reducing excessive head and trunk sway during self-paced walking in children and adolescents with cerebral palsy (CP).

      Design

      Quasi-experimental, proof-of-concept study with between-groups comparison.

      Setting

      Ambulant care facility, community center.

      Participants

      Children and adolescents (N=65), consisting of those with CP (spastic and ataxic, n=26; Gross Motor Function Classification System I–III; mean age, 9.8y; 11 girls, 15 boys) and those who were typically developed (TD, n=39; mean age, 10.0y; 23 girls, 16 boys).

      Interventions

      IPT applied by a therapist to locations at the back and the head.

      Main Outcome Measures

      As primary outcomes, head and trunk sway during self-paced walking were assessed by inertial measurement units. Secondary outcomes were average step length and gait speed.

      Results

      CP group: apex and occiput IPT reduced head velocity sway compared with thoracic IPT (both P=.04) irrespective of individuals' specific clinical symptoms. TD group: all testing conditions reduced head velocity sway compared with walking alone (all P≤.03), as well as in apex and occiput IPT compared with paired walking (both P≤.02).

      Conclusions

      Deliberately light IPT at the apex of the head alters control of head sway in children and adolescents with CP. The effect of IPT varies as a function of contact location and acts differently in TD individuals.

      Keywords

      List of abbreviations:

      CP ( cerebral palsy), GMFCS ( Gross Motor Function Classification System), HVS ( head velocity sway), IPT ( interpersonal touch), TD ( typically developed), TVS ( trunk velocity sway)
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