The effect of additional foot support with or without seat surface forward tilting on upper extremity function in children with spastic cerebral palsy*

Children with cerebral palsy (CP) often are faced with dysfunctional postural
control. Most children with CP spend a large part of the day in sitting
position. It is however debated which sitting condition (inclination of seat
surface, degree of postural support) in children with CP is associated with the
best functional performance in terms of good postural stability and in the
adequacy of upper extremity (UE) function.

To evaluate the effect of additional foot support during sitting and the effect
of forward tilting of the seat surface on 1) postural adjustments during
reaching and 2) the quality of reaching movement in school age children with
CP.

Intervention study with a repeated-measures design (sitting conditions x foot
support)

The children will be assessed in 4 sitting conditions.

The study is associated with minimal risks. The risk consist of falling of the
assessment table. This risk is minimized by the continuous presence of two
researchers in the childs vicinity. The burden of participation consists of
time investment of parents and children associated with travelling to the UMCG
and the assessment of 1-1* hour. The electrodes and markers used for EMG- and
kinematic recording are well tolerated by (young) children. The postural and
clinical assessments are carried out in a playful way. When children get tired,
the session will be ended. For child and family involved the potential benefit
is immediate knowledge on the effect of specific seating conditions on
functional activity, knowledge which they may apply in daily life. The major
benefit consists of a group benefit: children with CP certainly will profit
from increased knowledge on the best seating condition.