Ankle proprioception in children with cerebral palsy.
Elizabeth Boyer, Qiyin Huang, Stacy Ngwesse and 3 others
PMID 38007680WHAT IT FOUND
Children with cerebral palsy needed larger ankle position differences to detect movement than peers.
However, their consistency in judging positions was normal. This suggests the deficit is a shift in where they perceive neutral, not random error in sensing.
Key findings
01Children with CP had significantly higher just noticeable difference thresholds for ankle position than typically developing children, indicating impaired acuity.
02The uncertainty area, reflecting the consistency or precision of ankle position judgments, did not differ significantly between the groups.
03Sixty percent of children with CP fell within the third and fourth quartiles of the typically developing cohort's thresholds, while twenty percent exceeded the ninety-fifth percentile.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was a small proof-of-concept with only 15 children with CP, limiting the generalizability of the findings. The test was only feasible for children who could understand instructions and maintain attention, excluding those with intellectual disabilities or younger children (only 2 of 7 children under nine completed the test). Participants were all ambulatory (GMFCS levels I-III), so the results do not apply to children with more severe motor impairment. The typically developing group was tested at a state fair, which may have introduced environmental variability compared to the clinical setting for the CP group.
Declared interests
The authors have no conflicts of interest to report.
The easy way to misread this
Do not assume that impaired ankle proprioception in CP is due to inconsistent or noisy sensory signals. The study found that precision was normal; the deficit was a consistent shift in the threshold for detecting position change.