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Balance in relation to walking deterioration in adults with spastic bilateral cerebral palsy

OPHEIM A; JAHNSEN R; OLSSON E; STANGHELLE JK
PHYS THER , 2012, vol. 92, n° 2, p. 279-288
Doc n°: 156453
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.2522/ptj.20100432
Descripteurs : AD32 - SPASTICITE, AF93- PARALYSIE CEREBRALE ADULTE, DF23 - PATHOLOGIE - MARCHE, DF1 - EQUILIBRATION

Balance function is central in walking, and impaired balance function
may be related to walking deterioration in adults with spastic bilateral cerebral
palsy (CP). The purposes of this study were: (1) to compare balance
confidence, fear of falling, and balance ability in adults with spastic bilateral
CP, with and without self-reported walking deterioration; (2) to characterize
balance confidence, fear of falling, and balance ability across all participants;
and (3) to examine the relationship between balance confidence and balance
ability across all participants. DESIGN: A case-control design was used. METHODS:
Sixteen adults from a 7-year follow-up study who had spastic bilateral CP and
were under 40 years of age in the 2006 survey participated. Eight participants
reported walking deterioration (cases), and 8 participants did not report walking
deterioration (controls). Outcome variables were: the Activities-specific Balance
Confidence (ABC) Scale, the Falls Efficacy Scale-International (FES-I), and the
Balance Evaluation Systems Test (BESTest). RESULTS: No differences in any of the
outcome variables were found between the cases and the controls. Across all
participants, the ABC Scale and FES-I scores were 62% and 24 points,
respectively. Reduced ABC Scale scores and increased FES-I scores were found when
using escalators, walking in crowds, and walking on slippery surfaces. The
BESTest subscale scores were 60% to 79% of the maximum score, but only 31% and
42% of the maximum score in postural responses and anticipatory adjustments,
respectively. Balance confidence correlated positively with postural responses,
sensory orientation, stability in gait, and BESTest total score. LIMITATIONS: The lack of reliability and validity tests for the outcome variables in this study
population and the small number of participants were limitations of the study.
CONCLUSIONS: Self-reported walking deterioration in this group could not be
explained by differences in balance confidence, fear of falling, or balance
ability. Across all participants, most balance problems seemed related to reduced
postural responses and anticipatory adjustments.

Langue : ANGLAIS

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