Visual dependence affects postural sway responses to continuous visual field motion in individuals with cerebral palsy.
Yawen Yu, Richard T Lauer, Carole A Tucker and 2 others
PMID 29341797WHAT IT FOUND
Adults with spastic cerebral palsy who were visually dependent swayed more in the direction of a moving virtual scene than visually independent adults with cerebral palsy or typical development.
Their visual dependence also appeared linked to impaired vestibulo-ocular reflex.
Key findings
01Thirteen of the 23 participants with spastic CP were visually dependent, and this group made larger errors judging verticality than the visually independent CP and typically developing groups.
02Visual dependence was associated with impaired vestibulo-ocular reflex function, but not with light touch, pain, or vibration sensation in the feet.
03During moving visual scenes, the visually dependent CP group shifted its body sway in the direction of the scene more than the visually independent CP and typically developing groups, and showed larger front-to-back sway variability than with a static scene.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used a convenience sample of only 23 adults with CP, all of whom were Gross Motor Function Classification System level I or II and could stand unsupported for at least 2 minutes. It therefore says little about adults with CP who need more assistance or cannot stand. The outcomes were laboratory sway measures in virtual reality, not falls, walking, or daily activities. The visual perturbation was only forward-backward rotation, so sideways or multi-directional visual motion was not tested. The study compared groups at one time and cannot show that visual dependence causes the sway responses.
The easy way to misread this
Do not conclude that adults with cerebral palsy have a treatable visual dependence problem that explains their balance difficulties. The study was a small laboratory comparison of people who could already stand unsupported for at least 2 minutes, and it measured sway in virtual reality, not falls or daily function.