Moreover, these children demonstrate deficiency in anticipatory postural adjustments while standing and walking. They also experience difficulty with planning of motor responses, in response to support surface perturbations due to delayed onset of muscle activation. Consequently, they have balance impairments in altered sensory environments, and tend to depend excessively on visual input to maintain posture and to position their limbs during gait, which may indicate proprioception deficits. Children with diplegic CP encounter difficulties in sensory processing and integration which influence the achievement of mature postural control. Spastic diplegia is one of the most common types of CP in which lower limbs are affected more than upper limbs. Additionally, spasticity causes changes in muscle fibers that may impede the JPS influencing the connection between muscles and joints and also affecting muscle spindle sensitivity.
#Balance test eyes closed hands out knees up walking skin
Proprioception deficits in cerebral palsy (CP) are most likely due to central nervous system lesions, which impact proprioceptive inputs coming from muscle spindles, Golgi tendon organs, and sensory innervations of joints and skin to the cortex. Joint position sense (JPS) recognizes movement of joints, and assumes an essential role in gait and postural control.
Regarding all the sensory inputs, proprioception is viewed as the one most firmly connected to locomotor activity. Therefore, in the event of lessened contribution of one sensory framework, other frameworks may be required to expand their involvement to assure achievement of a task.
In visual deprivation, posture is modified through sensory inputs from vestibular, proprioceptive, and tactile frameworks. Considering locomotion, the visual system recognizes feedback or feedforward information concerning alterations in the walking pathway, enhancing postural adjustment according to the environment. Participation of each sensory framework varies according to environmental circumstances. The network of the vestibular, proprioceptive and visual systems is crucial for typical motor responses, balance control, and mobility. Appropriate postural control requires integration of sensory and motor systems.
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