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)To read this article in full you will need to make a payment
Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- International Classification of Functioning, Disability and Health in children with cerebral palsy.Disabil Rehabil. 2012; 34: 1053-1058
- Upper body accelerations during walking in healthy young and elderly men.Gait Posture. 2004; 20: 291-298
- Upper body movements in children with hemiplegic cerebral palsy walking with and without an ankle-foot orthosis.Clinical Biomech (Bristol, Avon). 2014; 29: 387-394
- Altered trunk movements during gait in children with spastic diplegia: compensatory or underlying trunk control deficit?.Res Dev Disabil. 2014; 35: 2044-2052
- Trunk movements during gait in cerebral palsy.Clinical Biomech (Bristol, Avon). 2015; 30: 28-32
- Clinical characteristics of impaired trunk control in children with spastic cerebral palsy.Res Dev Disabil. 2013; 34: 327-334
- Head stabilization strategies in the sagittal plane during locomotor tasks.Physiother Res Int. 2004; 9: 33-42
- Head stabilization during various locomotor tasks in humans. II. Patients with bilateral peripheral vestibular deficits.Exp Brain Res. 1991; 85: 208-217
- Postural orientation and equilibrium.in: Rowell L.B. Shepherd J.T. Handbook of physiology. Section 12. Exercise: regulation and integration of multiple systems. Oxford University Pr, New York1996: 255-292
- Use of sensory information during postural control in children with cerebral palsy: systematic review.J Mot Behav. 2015; 47: 291-301
- Effect of light touch on postural sway in individuals with balance problems: a systematic review.Gait Posture. 2014; 40: 1-10
- Contrasting effects of finger and shoulder interpersonal light touch on standing balance.J Neurophysiol. 2012; 107: 216-225
- Somatosensory driven interpersonal synchrony during rhythmic sway.Hum Mov Sci. 2012; 31: 553-566
Johannsen L, McKenzie E, Brown M, Redfern MS, Wing AM. Deliberately light interpersonal touch as an aid to balance control in neurologic conditions. Rehabil Nurs. 2014 Dec 7. [Epub ahead of print].
- Effects of different types of light touch on postural sway.Exp Brain Res. 2002; 147: 71-79
- Passive tactile sensory input improves stability during standing.Exp Brain Res. 2001; 136: 514-522
- A multisensory posture control model of human upright stance.Prog Brain Res. 2003; 142: 189-201
- Validation of a model of gross motor function for children with cerebral palsy.Phys Ther. 2000; 80: 974-985
- Trunk and head stabilization during the first months of independent walking.Neuroreport. 1995; 6: 1737-1740
- The role of head stabilization in locomotion in children with cerebral palsy.Ann Phys Rehabil Med. 2012; 55: 590-600
- Differences between the family-centered “COPCA” program and traditional infant physical therapy based on neurodevelopmental treatment principles.Phys Ther. 2011; 91: 1303-1322
- A speedy solution for balance and gait analysis: angular velocity measured at the centre of body mass.Curr Opin Neurol. 2005; 18: 15-21
Article Info
Publication History
Published online: February 28, 2017
Footnotes
Supported by the Federal Ministry of Education and Research of Germany (BMBF; grant no. 01EO1401) and by the Deutsche Forschungsgemeinschaft through the TUM International Graduate School of Science and Engineering.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
