title: Impaired visually guided weight-shifting ability in children with cerebral palsy.
abstract: The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7-12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength.
authors.affiliation: Department of Kinanthropology, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8; Centre de Réadaptation Marie Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, QC, Canada H1T 1C9; Groupe de recherche en activité physique adaptée (GRAPA), C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8. Electronic address: laurent.ballaz@uqam.ca.
authors.forename: Laurent
authors.initials: L
authors.lastname: Ballaz
authors.affiliation: Centre de Réadaptation Marie Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, QC, Canada H1T 1C9.
authors.forename: Maxime
authors.initials: M
authors.lastname: Robert
authors.affiliation: Centre de Réadaptation Marie Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, QC, Canada H1T 1C9; Department of Biomedical Engineering, École polytechnique de Montréal, C.P. 6079, succursale Centre-Ville, Montréal, QC, Canada H3C 3A7.
authors.forename: Audrey
authors.initials: A
authors.lastname: Parent
authors.affiliation: Department of Kinesiology, Université de Montréal, Montreal (Qc), CEPSUM, 2100, boul. Édouard-Montpetit, C.P. 6128, succursale Centre-ville, Montréal, QC, Canada H3C 3J7.
authors.forename: François
authors.initials: F
authors.lastname: Prince
authors.affiliation: Department of Kinanthropology, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8; Centre de Réadaptation Marie Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, QC, Canada H1T 1C9; Groupe de recherche en activité physique adaptée (GRAPA), C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8.
authors.forename: Martin
authors.initials: M
authors.lastname: Lemay
mesh_terms: D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D010775:Photic Stimulation; D004856:Postural Balance / Q000502:physiology*; D012865:Skiing / Q000502:physiology; D018910:Video Games; D016474:Weight-Bearing / Q000502:physiology*
keywords: Active video game; Assessment; Cerebral palsy; Weight-shifting