Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study

Issue title: Cerebral Palsy

Guest editors: Deborah Gaebler-Spira and Michael Green

Article type: Research Article

Authors: Zarkou, Anastasia^{a; *} | Lee, Samuel C.K.^{b; c; d} | Prosser, Laura^{e; f} | Hwang, Sungjae^g | Franklin, Corinna^d | Jeka, John^h

Affiliations: [a] Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA, USA | [b] Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA | [c] Department of Physical Therapy, University of Delaware, Newark, DE, USA | [d] Research Department, Shriners Hospital for Children, Philadelphia, PA, USA | [e] Division of Rehabilitation Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA | [f] Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA | [g] Department of Kinesiology, University of Maryland Eastern Shore, Princess Anne, MD, USA | [h] Department of Kinesiology, University of Delaware, Newark, DE, USA

Correspondence: [*] Corresponding author: Anastasia Zarkou, Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, 2020 Peachtree Road NW, Atlanta, GA, 30309, USA. Tel.: +1 404 603 4200; E-mail: [email protected].

Abstract: PURPOSE: To investigate foot and ankle somatosensory function in children with cerebral palsy (CP). METHODS: Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I–III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed. RESULTS: Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints. CONCLUSIONS: These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.

Keywords: Cerebral palsy, sensory processing, sensation, proprioception, somatosensory function, sensory thresholds

DOI: 10.3233/PRM-190643

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 2, pp. 247-255, 2021