| Summary: | 碩士 === 國立成功大學 === 物理治療研究所 === 94 === Background and Purpose: Seated reaching is critical for upper extremity movement in carrying out daily living activities in children with cerebral palsy (CP). Several studies have concluded that the seat surface inclination is an important factor to improve postural stability during functional movement, such as reaching. However, the optimal seat surface inclination is still disputed. The purpose of the study was to examine the effects of seat surface inclination on postural stability and reaching efficiency during a self-paced forward reaching in children with and without CP. Methods: Ten children (6 boys, 4 girls; aged: 7.8 ± 1.48 years) with CP and sixteen children (8 boys and 8 girls; aged: 8.85 ± 1.89 years) without CP were recruited. Each child first received physical examination and pediatric reach test. During a trial, a child was asked to be seated and press a switch at a distance of 140% arm length distance at listening a verbal cue. A flat seat surface and three degrees (5 o, 10 o and 15 o) of inclination in two directions seat surface conditions were randomly assigned. Center of pressure variables derived from ground reaction force, EMG data of lower extremities, reaction time and movement time were collected and used as dependent variables. Two-way ANOVA with repeated measure was used to compare the effects of group, inclination direction, degrees and their interaction. EMG data were analyzed descriptively. Results: The results showed that the children with CP presented more postural instability and reaching inefficiency than children without CP in all test conditions. But the children with CP showed more weight bearing of lower extremities and better postural stability (more straight forward movement of COP and less medial-lateral movement of COP) during reaching in anterior inclined seat surface. Moreover, the reaction time and movement time were shorter in the anterior inclined than in the posterior inclined seat surface conditions. The patterns of muscle activation were variable, but the dorsal side muscles demonstrated more consistently patterns than the anterior side, especially during an anterior inclined seat surface test condition. Conclusions: The anterior inclined seat surface may allow children with CP to increase the contribution of the lower extremities for weight bearing and show better postural stability during a forward reaching. The reaction time and movement of arm reaching are also shorter in the anterior inclined seat surface conditions. Clinical Relevance: Findings may be used as reference for seat design and rehabilitation training for children with postural control difficulties.
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