Head stability during quiet sitting in children with cerebral palsy: effect of vision and trunk support

Deficits in postural control are one of the hallmarks of disability in children with cerebral palsy (CP). Yet, much remains unknown regarding the etiology of postural deficits in these children. Here we evaluated postural control at a simplified task level by measuring head stability during quiet sitting while systematically manipulating the level of trunk support and vision in 15 children with CP (6-16 years), 26 typically developing (TD) children (4-14 years), and 11 adults. While TD children did not differ significantly from adults, children with CP had greater head movement than adults in both the sagittal and frontal planes under all conditions except frontal plane movement with Torso Support. Vision did not affect head stability in the sagittal plane for any group while it had differential effects on head stability in the frontal plane. Lack of vision improved head stability in adults and older TD children while destabilizing the head in young children (TD and CP) during the most unstable sitting position. Moreover, vision affected children with CP differently depending on their movement disorder. Children with spastic CP performed worse with eyes closed while those with dyskinetic CP had improved head stability with eyes closed. Our results demonstrate that children with mild to moderate CP have deficits in head stability even during quiet sitting.