Single leg hopping in children with and without Fetal Alcohol Spectrum Disorder: a descriptive study of dynamic postural stability and kinematics

[摘要] ENGLISH SUMMARY : Introduction: Fetal Alcohol Spectrum Disorder (FASD) is a leading preventable cause of acquired developmental disabilities. Impairments of motor function and dynamic postural stability (DPS) are found in children with FASD. These impairments may negatively impact on these children's ability to perform their required activities of daily living and engage with their peers in play and sporting activities. To date no research has been conducted on DPS in children with FASD in South Africa.Aim: DPS and kinematics during single leg hopping were described in two groups of typically developed nine-year-old children from an urban and rural setting (controls) and a group of nine-year-old children with FASD from a rural setting (cases). Any differences in DPS and kinematics between the three groups were also determined.Purpose of the studyIdentifying and describing potential motor and DPS impairments in South African children with FASD will add to the body of available research and could provide the basis for the development of interventions aimed at improving overall motor function of these children, and therefore their ability to participate better in their activities of daily living.Methodology: Participants performed a consecutive single leg hopping task and landed on a pressure mat to stabilise on one leg. Motion analysis systems and a pressure mat were used to describe 1) spatiotemporal and centre of pressure (COP) parameters and 2) joint kinematics i.e. hip, knee and ankle angles in the sagittal plane. Spatiotemporal parameters included stance and swing times and speed. COP parameters included anteroposterior (AP) and mediolateral (ML) velocity and range of motion (ROM). Descriptive results are presented in median and ranges and differences between groups were determined by Kruskal-Wallis and Mann-Whitney U statistical tests. The level of significance was set at p<0.05.Results: Fifty-six children participated; 14 children with FASD (cases), 14 rural controls and 28 urban controls. The urban controls had statistically significant longer stance and swing times (p<0.001) than the case and rural control groups. COP parameters were not statistically significantly different; however the case group displayed greater AP velocity and AP ROM values compared to both control groups (APvel: p=0.78; APROM: p=0.66). In terms of kinematics, the urban controls hopped with statistically significant greater hip flexion compared to the case group (p=0.017). Rural and urban controls hopped with more knee flexion compared to the case group, although this was not significant (p=0.16). The cases and rural controls showed statistically significant greater knee flexion at initial foot contact (IFC) onto the pressure mat than the urban controls (cases and urban controls: p=0.04; rural and urban controls: p<0.001). The urban control group landed in statistically significant more plantarflexion at IFC onto the mat than the case group (p<0.001) and the rural control group (p=0.03) and during landing, the urban control group moved into statistically significant more hip flexion compared to the case group (p=0.015) and the rural control group (p= 0.026).Conclusion: The differences in spatiotemporal, COP and kinematic parameters highlight different movement strategies and DPS capabilities between the groups. The case group hopped in a more extended position of the lower limbs and displayed increased COP AP velocity and ROM compared to the control groups, which may be an indication of impaired DPS. Identifying and exploring the aspects that underlie these impairments through objective measurement methods may assist in the development of evidence-based physiotherapy treatments for these children. This is the first study of its kind in South Africa and further research is warranted.

[发布机构] Stellenbosch University