Kinematics and Posture in Children With Spastic Diplegic Cerebral Palsy: Role Of Pelvis

Children with CP often lack pelvic movement, with increased resistance to movement throughout range. Pelvic movement may be limited by increased postural tone or muscle tone in specific muscles and/or abnormal reciprocal innervation, i.e., hypoextensible musculature may mechanically constrain movement and characteristically widespread co-contraction in abnormal synergies increase limb stiffness and resistance to movement (Campbell, 1990). In some children with CP the hamstring muscles are spastic, exerting a force of backward rotation (posterior tilt) on the pelvis (Myhr and von Wendt, 1990) which limits anterior tilt. Conversely, some children may have increased spasticity in the hip flexors, pulling the pelvis into anterior tilt, and restricting posterior tilt. Although children, parents and physiotherapists often subjectively note changes in motor performance, there has been little actual research to substantiate the role of pelvic movements.The aim of this study was to detect if the pelvic control exercises would improve posture in children with CP.