Anteroposterior balance reactions in children with spastic cerebral palsy.

The sample was small and convenience-based: 21 children with CP and 29 typically developing children were enrolled, but 17 children with CP and 28 typically developing children completed the balance-reaction test. The planned sample was 25 children with CP and 25 typically developing children, so recruitment fell short of the intended power. The children with CP were high-functioning, mostly GMFCS level I or II, walked without aids, and had mild spasticity, so results may not apply to children with more severe involvement. The study was cross-sectional, so it cannot show that balance reactions decline with age or that CP causes the difference. EMG analyses used fewer participants because the first pilot group and two children with ankle-foot orthoses were not included, and outliers were removed. Two children with CP and one typically developing child could not follow directions, and two children with CP ended the test early due to non-physical distress. The authors did not measure lower-limb strength or knee and hip responses, and the margin-of-stability method assumes ankle control can position pressure instantly. The clinical balance test comparison was limited by ceiling effects and weak correlations with stepping thresholds.

The supplied text does not include a conflict-of-interest declaration. The publication types indicate research support from NIH extramural and non-U.S. government sources.

Do not conclude that children with spastic CP have impaired reactive balance in all directions or at all ages. The group difference was mainly for older children in the forward direction, and posterior thresholds did not differ between groups.