Your Therapy Source Magazine for Pediatric Therapists September 2016 | Page 21

VISUAL STIMULI AND STANDING POSTURE IN
CHILDREN WITH CEREBRAL PALSY
BMC Neurology published
research on visual stimuli
and standing posture in 36
children with bilateral
cerebral palsy (CP) and 27
typically developing (TD)
children. Standing
independently requires the
visual, somatosensory,
and vestibular
systems. Using threedimensional motion
an alysis with surface
electromyography to
describe body position,
body movement,
and muscle activity during three standing tasks, the researchers examined standing in a selfselected position, while blindfolded, and during an attention-demanding task. For the
participants with cerebral palsy, 17 required support for standing (CP-SwS) and 19 stood without
support (CP-SwoS). The results indicated the following:
 all children with CP stood with a more flexed body position than the TD children, even
more pronounced in the children in CP-SwS.
 during blindfolded standing, the CP-SwS group further flexed their hips and knees, and
increased muscle activity in knee extensors.
 during blindfolded standing, the children in CPSwoS group maintained the same body
position but increased calf muscle activity.
 during the attention-demanding task, the children in CP-SwoS stood with more still head
and knee positions and with less muscle activity.
The researchers concluded that visual input was important for children with CP to maintain a
standing position. Without visual input the children who required support dropped into a further
crouched position. The somatosensory and vestibular systems alone could not provide enough
information about the body position in space without visual cues. For the children who stood
without support, increasing the visual stimulus improved the ability to maintain a quiet standing
position. The researchers hypothesize that impairments in the sensory systems are major
contributors to the difficulties to stand erect in children with CP.
Reference: Lidbeck C, Bartonek Å, Yadav P, Tedroff K, Åstrand P, Hellgren K, GutierrezFarewik EM. The role of visual stimuli on standing posture in children with bilateral cerebral
palsy. BMC Neurol. 2016 Aug 24;16(1):151. doi: 10.1186/s12883-016-0676-2. Read the full
article here.
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