A descriptive analysis of abnormal postural patterns in children with hemiplegic cerebral palsy

BACKGROUND Functional classification systems generally divide children with cerebral palsy (CP) into mild, moderate, and severe types. Although depending on functional limitations, they do not seem to evaluate abnormal postural patterns in standing. Since the most asymmetrical patterns can be observed in hemiplegia, the goal of this case series study was to provide their objective analysis and to establish any potential clinical value for evaluation and management of CP. MATERIAL/METHODS A group of 36 children (aged 5-10 years) with spastic hemiplegic CP, who could stand and ambulate independently, were selected. The photogrammetric and pedobarographic studies were obtained for the postural analysis in standing. RESULTS Two different anti- and pro- gravitational postural patterns were identified. They seem not only to affect functional status and rehabilitation potential, but also clinical value for evaluation and management of CP hemiplegia. CONCLUSIONS The importance of strong study design cannot be overemphasized. The 2 different postural patterns indicate dissimilar compensatory tendencies, which may help in prognosis of deformity and functional outcomes of rehabilitation. The use of objective photogrammetric and the pedobarographic studies may also help to develop a more specific therapeutic intervention in order to facilitate the pattern leading towards better outcome (orthosis in the anti-gravitational postural pattern vs focal spasticity management in the pro-gravitational postural pattern).