Evaluation of sense of position and agency in children with diplegic cerebral palsy: A pilot study

Issue title: Cerebral Palsy

Guest editors: Deborah Gaebler-Spira, Michael Green and Heakyung Kim

Article type: Research Article

Authors: Cristella, Giovanna^a | Allighieri, Martina^a | Pasquini, Guido^{a; *} | Simoni, Laura^{a; b} | Antonetti, Antonella^a | Beni, Chiara^a | Macchi, Claudio^a | Ferrari, Adriano^c

Affiliations: [a] IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy | [b] Department of Neurosciences, Biomedicine and Movement Science, University of Verona, Verona, Italy | [c] Physical and Rehabilitation Medicine, CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy

Correspondence: [*] Corresponding author: Guido Pasquini, Laboratorio Analisi del Movimento, IRCSS Fondazione Don Carlo Gnocchi Firenze, Italy. Tel.: +39557393657; Fax: +3955739301; E-mail: [email protected].

Abstract: PURPOSE:This study explores non-motor impairment of the upper dominant limb in children with diplegic cerebral palsy (CP). Specifically, it firstly investigates sense of position without visual control, ability to compare visual and proprioceptive information, and capacity to recognize effects of self-movement. Secondly, it explores the possible association between these items with cognitive function, perceptual disorder (PD), and manual ability (Manual Ability Classification System -MACS). METHODS:Ten subjects (7 female; 3 male) were tested with three protocols: the first one (A) explored sense of position, the second one (B) collimation between visual and proprioceptive information, and the last one (C) sense of agency with the use of videogames. RESULTS:All subjects executed Protocol A without making any mistakes, while in Protocol B the median percentage of mistakes was 4.8%. Mistakes were recorded more frequently in positions characterized by wrist extension. Data reported a significant correlation with Processing Speed Index (PSI). Sense of agency was positively associated with cognitive functioning, with a significant correlation with PSI.PD, MACS, and Video-Gaming Experience (VGE) showed no correlation with Protocol C. CONCLUSION:In the observed sample with diplegic CP, preliminary data support the hypothesis that there is an alteration of both sense of position and sense of agency. They were both associated to PSI, with a positive trend of correlation with cognitive functioning. PD seemed to have no influence. Further studies, with a larger sample size, a control group, and involving children without CP, are required to corroborate the results obtained.

Keywords: Sense of position, sense of agency, upper limb rehabilitation, cerebral palsy

DOI: 10.3233/PRM-200703

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 15, no. 1, pp. 181-191, 2022