Head position and head movement in children with Cerebral Palsy

Abstract

In this investigation three different methods were used to explore head position and head movement, a video based checklist, 2D motion analysis of horizontal and vertical displacement in the sagittal plane, and semi structured interviews with children with impaired head control and their parents and teachers.

In the first stage of the research an 18 time video based observation checklist was developed to assess head position and head movement in children with CP.  Checklist content was identified from four sources (two researchers conducted independent content analysis), a literature review, observation of children with CP and consultation with paediatric therapists and researchers experienced in movement analysis.  The checklist was used to rate videos of 20 children without neurological impairments and 10 children with CP during three activities, each of which was filmed for three minutes (listening, talking and using a computer).  All of the children with CP used special seating.  Development of the checklist has identified important parameters of head position and head movement in children with CP, however the results of reliability testing indicate it is not suitable for use as an outcome measure.

In the second stage video data was re-examined using 2D motion analysis (horizontal and vertical displacement in the sagittal plane).  The results highlight variability of head position and head movement in both groups of children.  Most children with CP showed distinctly different movement characteristics during each activity.  All but one of the children with CP had a head support on their seating system (most of whom used head supports) the mean range of horizontal and vertical displacement was 12-61 cms and 11-61cms respectively and the maximum ranges of displacement exhibited was 29cms.  The results of the 2D analysis highlight the inadequately of using a postural rating at one moment in time to represent head positions in children with CP.

In the third stage of the research 30 semi structured interviews were conducted.

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