Eye movements and postural alignment in children with cerebral palsy

[摘要] English: The level of severity of disability may have increased among children with cerebral palsy and therefore continued monitoring of the characteristics of children with cerebral palsy is necessary. Cerebral palsy (CP) can be considered as a sensory-motor disorder that results from malformations in the developing brain that disrupts the development of the neuronal network and cortical and sub-cortical pathways. Although the motor behaviours and postural deficits are defining features of CP, visual disorders are a main symptom in the clinical picture of CP. There are well sounded reasons why children with CP have difficulties to partake in everyday activities. Neurologic pathology can affect specific aspects of postural control including the ability to maintain stability with alignment in a specific position. Postural control is necessary for maintaining all body segments in an upright position and to orientate the eyes to the environment. Problems with the visual system in CP include peripheral problems related to the anterior part of the visual system, visual problems of central origin and cerebral visual impairment. Observations of eye movements and postural alignment in sitting in children with CP were the focus of this study. These are variables known to potentially influence occupational-based activities. The aim of the study was to describe eye movements and postural alignment and to investigate if there was a possible association between eye movements and postural alignment in sitting in a frontal plane of children with CP, between the age of two and ten years. A non-experimental, quantitative approach addressed the aim. A descriptive study was used to describe the eye movements and alignment in body segments over the base of support against gravity. A correlation study was used to investigate the possible association between postural alignment and eye movements in children with CP. Following the pilot study the unstructured and structured observations were administered to a convenience sample of children with CP attending a clinic, school or a private practice. Fifty seven children with CP, between two and ten years of age participated in the study after meeting the pre-determined inclusion criteria. The data collected were numbers that reflected specific measurements of the characteristics in question and were analysed by using a grounded, observed �?clinical reasoning approach. The mean age of the children was 5.3 years (SD = 2.26). Discussion of results was directed at describing eye movements and postural alignment and interpreting the implications of those associations for clinical practice. The obtained data from the unstructured and structured observations were statistically analysed and compared and did produce a statistically significant positive association between eye movements and postural alignment therefore, both the posture and the eye movements are critical to the provision of intervention. The study confirms the association between eye movements and postural alignment in sitting in children with CP. This study has documented the difficulties the child with CP has to encounter. This may facilitate the establishment of effective and appropriate measuring instruments for occupational therapists, assessing functional vision and postural alignment in any setting of practice.

[发布机构] University of the Free State