Sensory processing abilities, postural stability, and selective motor control in children with hemiplegic cerebral palsy: a cross-sectional study

Authors

  • Reham Fathi Fouad Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, South Valley University, Qena, Egypt.
  • Shimaa Mohamed Reffat Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.Cairo university
  • Samah Attia El Shemy Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

DOI:

https://doi.org/10.68574/sportk.381

Keywords:

Sensory Processing Abilities, Postural Stability, Selective Voluntary Motor Control, Hemiplegia, Cerebral Palsy

Abstract

This study aimed to assess sensory processing abilities, selective voluntary motor control (SVMC) and postural stability among children with hemiplegic cerebral palsy (CP) and to compare hemiplegic CP and age-matched typically developing children (TDC). The ages of the children that took part in the study varied from 6 to 10 years old, and they included 30 TDC and 30 hemiplegic CP. Outcomes were assessed using: (a) the Child Sensory Profile 2 (CSP-2) to evaluate sensory processing; (b) the Test of Arm Selective Control (TASC) and the Selective Control Assessment of the Lower Extremity (SCALE) to assess selective voluntary motor control (SVMC) of the upper and lower extremities, respectively; and (c) the HUMAC Balance System to evaluate postural stability. The findings of the current study revealed statistically substantial reduction in HUMAC Balance System test scores of modified clinical test of sensory integration and balance (mCTSIB), center of pressure (COP) and limit of stability (LOS) 4 and 6 in children having hemiplegic CP in comparison with TDC (p< 0.001) respectively. A substantial decline was found in SCALE and TASC scores among children having hemiplegia in comparison with that of TDC (p<0.001) while children with hemiplegic CP exhibited significantly higher scores compared to TDC across various sections of CSP-2. Children with hemiplegic CP have significant deficits in sensory processing abilities, postural control and selective voluntary motor control compared to TDC that could guide clinical practice and decision-making process for effective rehabilitation.

Downloads

Download data is not yet available.

References

1. Abd Elaziz, A. A., Ibrahim, A. F., & El Shemy, S. A. (2024). Joint position sense and balance in children with hemiplegia in comparison with typically developing controls: A cross-sectional African Journal of Biological Sciences, 6(13), 6774-9474.

2. Al-Heizan, M. O., AlAbdulwahab, S. S., Kachanathu, S. J., & Natho, M. (2015). Sensory processing dysfunction among Saudi children with and without autism. Journal of Physical Therapy Science, 27(5), 1313–1316. https://doi.org/10.1589/jpts.27.1313

3. Almeida, G. P. L., Monteiro, I. O., Marizeiro, D. F., Maia, L. B., & de Paula Lima, P. O. (2017). Y balance test has no correlation with the Stability Index of the Biodex Balance System. Musculoskeletal Science & Practice, 27, 1–6. https://doi.org/10.1016/j.msksp.2016.11.008

4. Alsalaheen, B., Haines, J., Yorke, A., & Broglio, S. P. (2015). Reliability and Construct Validity of Limits of Stability Test in Adolescents Using a Portable Forceplate System. Archives of Physical Medicine and Rehabilitation, 96(12), 2194–2200. https://doi.org/10.1016/j.apmr.2015.08.418

5. Alves-Pinto, A., Blumenstein, T., Turova, V., & Lampe, R. (2016). Altered lower leg muscle activation patterns in patients with cerebral palsy during cycling on an ergometer. Neuropsychiatric Disease and Treatment, 12, 1445–1456. https://doi.org/10.2147/NDT.S98260

6. Blank, R., von Kries, R., Hesse, S. & von Voss, H. (2008). Conductive education for children with cerebral palsy: effects on hand motor functions relevant to activities of daily living. Archives of Physical Medicine and Rehabilitation, 89(2), 251-259.

7. Bohannon, R. W., & Smith, M. B. (1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy, 67(2), 206–207. https://doi.org/10.1093/ptj/67.2.206

8. Bundy, A. C., & Lane, S. J. (2020). Sensory integration: Theory and practice (3rd ed.). F. A. Davis.

9. Cahill-Rowley, K., & Rose, J. (2014). Etiology of impaired selective motor control: emerging evidence and its implications for research and treatment in cerebral palsy. Developmental Medicine and Child Neurology, 56(6), 522–528. https://doi.org/10.1111/dmcn.12355

10. Dean, E., Dunn, W., & Little, L. (2016). Validity of the sensory profile 2: a confirmatory factor analysis. The American Journal of Occupational Therapy, 70(4), 1-16.

11. Dounskaia, N., Peterson, D., & Bruhns, R. P. (2018). Destabilization of the upright posture through elevation of the center of mass. Annals of Biomedical Engineering, 46(2), 318-323. https://doi.org/10.1007/s10439-017-1957-7

12. Dunn, W. (2014). Child Sensory Profile–2 user’s manual. Bloomington, MN: Pearson.

13. Dunn, W., & Daniels, D. B. (2002). Initial development of the infant/toddler sensory profile. Journal of Early Intervention, 25(1), 27-41.

14. El-Shamy S. M. (2018). Efficacy of Armeo® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children with Hemiplegic Cerebral Palsy. American Journal of Physical Medicine & Rehabilitation, 97(3), 164–169. https://doi.org/10.1097/PHM.0000000000000852

15. Erkek, S., & Çekmece, Ç. (2023). Investigation of the Relationship between Sensory-Processing Skills and Motor Functions in Children with Cerebral Palsy. Children (Basel, Switzerland), 10(11), 1-17. https://doi.org/10.3390/children10111723

16. Ferdjallah, M., Harris, G. F., Smith, P., & Wertsch, J. J. (2002). Analysis of postural control synergies during quiet standing in healthy children and children with cerebral palsy. Clinical Biomechanics (Bristol, Avon), 17(3), 203–210. https://doi.org/10.1016/s0268-0033(01)00121-8

17. Fontes, P. L. B., Cruz, T. K. F., Souto, D. O., Moura, R., & Haase, V. G. (2017). Body representation in children with hemiplegic cerebral palsy. Child Neuropsychology, 23(7), 838–863. https://doi.org/10.1080/09297049.2016.1191629

18. Fowler, E. G., Staudt, L. A., & Greenberg, M. B. (2010). Lower-extremity selective voluntary motor control in patients with spastic cerebral palsy: increased distal motor impairment. Developmental Medicine and Child Neurology, 52(3), 264–269. https://doi.org/10.1111/j.1469-8749.2009.03586.x

19. Fowler, E. G., Staudt, L. A., Greenberg, M. B., & Oppenheim, W. L. (2009). Selective Control Assessment of the Lower Extremity (SCALE): development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy. Developmental Medicine and Child Neurology, 51(8), 607–614. https://doi.org/10.1111/j.1469-8749.2008.03186.x

20. Gan, S. M., Tung, L. C., Tang, Y. H., & Wang, C. H. (2008). Psychometric properties of functional balance assessment in children with cerebral palsy. Neurorehabilitation and Neural Repair, 22(6), 745-753. https://doi.org/10.1177/1545968308316474

21. Gulati, S., & Sondhi, V. (2018). Cerebral Palsy: An Overview. Indian journal of pediatrics, 85(11), 1006–1016. https://doi.org/10.1007/s12098-017-2475-1

22. Jorquera-Cabrera, S., Romero-Ayuso, D., Rodriguez-Gil, G., & Triviño-Juárez, J. M. (2017). Assessment of Sensory Processing Characteristics in Children between 3- and 11-Years Old: A Systematic Review. Frontiers in Pediatrics, 5(2), 1-18. https://doi.org/10.3389/fped.2017.00057

23. Jovellar-Isiegas, P., Resa Collados, I., Jaén-Carrillo, D., Roche-Seruendo, L. E., & Cuesta García, C. (2020). Sensory Processing, Functional Performance and Quality of Life in Unilateral Cerebral Palsy Children: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 17(19), 1-17. https://doi.org/10.3390/ijerph17197116

24. Kenis-Coskun, O., Giray, E., Eren, B., Ozkok, O., & Karadag-Saygi, E. (2016). Evaluation of postural stability in children with hemiplegic cerebral palsy. Journal of Physical Therapy Science, 28(5), 1398–1402. https://doi.org/10.1589/jpts.28.1398

25. Kiefer, A. W., Armitano-Lago, C. N., Cone, B. L., Bonnette, S., Rhea, C. K., Cummins-Sebree, S., & Riley, M. A. (2021). Postural control development from late childhood through young adulthood. Gait & Posture, 86, 169-173. https://doi.org/10.1016/j.gaitpost.2021.02.030

26. Koltermann, J. J., Gerber, M., Beck, H., & Beck, M. (2017). Validation of the HUMAC balance system in comparison with conventional force plates. Technologies, 5(3), 1-12. https://doi.org/10.3390/technologies5030044

27. Kuo, H. C., Gordon, A. M., Henrionnet, A., Hautfenne, S., Friel, K. M., & Bleyenheuft, Y. (2016). The effects of intensive bimanual training with and without tactile training on tactile function in children with unilateral spastic cerebral palsy: A pilot study. Research in Developmental Disabilities, 49-50, 129–139. https://doi.org/10.1016/j.ridd.2015.11.024

28. Lim H. (2015). Correlation between the selective control assessment of lower extremity and pediatric balance scale scores in children with spastic cerebral palsy. Journal of Physical Therapy Science, 27(12), 3645–3649. https://doi.org/10.1589/jpts.27.3645

29. Lotfi, Y., Javanbakht, M., Sayaf, M., & Bakhshi, E. (2018). Modified clinical test of sensory interaction on balance test use for assessing effectiveness of Epley maneuver in benign paroxysmal positional vertigo patients' rehabilitation. Auditory and Vestibular Research, 27(1), 12-18.

30. Louwrens, S. (2018). Sensory Modulation Patterns in Children with Cerebral Palsy: A Comparative-Descriptive Study. University of Pretoria (South Africa). Available from: http://hdl.handle.net/2263/67775 .

31. Mahesan, A., Jauhari, P., Singhal, M., Gulati, S., Chakrabarty, B., Sirolia, V., & Pandey, R. M. (2024). A Relook at Cerebral Palsy Beyond Motor Pathology: A Cross-Sectional Study of Sensory Processing Abilities. Neurology India, 72(3), 590–596. https://doi.org/10.4103/ni.ni_1108_22

32. Newell, A., Cherry, S., & Fraser, M. (2020). Principles of rehabilitation: Occupational and physical therapy. In Orthopedic care of patients with cerebral palsy: A clinical guide to evaluation and management across the lifespan (pp. 221–250). Springer. https://doi.org/10.1007/978-3-030-46574-2_11

33. Niiler, T. A. (2018). Assessing dynamic balance in children with cerebral palsy. In Cerebral palsy (pp. 1-32). Springer, Cham. https://doi.org/10.1007/978-3-319-74558-9_49

34. O'Brien, S. M., Lichtwark, G. A., Carroll, T. J., & Barber, L. A. (2020). Impact of Lower Limb Active Movement Training in Individuals with Spastic Type Cerebral Palsy on Neuromuscular Control Outcomes: A Systematic Review. Frontiers in Neurology, 11, 1-15. https://doi.org/10.3389/fneur.2020.581892

35. Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine and Child Neurology, 50(10), 744–750. https://doi.org/10.1111/j.1469-8749.2008.03089.x

36. Park, M. O. (2017). The relationship between sensory processing abilities and gross and fine motor capabilities of children with cerebral palsy. Journal of The Korean Society of Physical Medicine, 12(2), 67-74. https://doi.org/10.13066/kspm.2017.12.2.67

37. Patel, D. R., Neelakantan, M., Pandher, K., & Merrick, J. (2020). Cerebral palsy in children: a clinical overview. Translational Pediatrics, 9, 125–135. https://doi.org/10.21037/tp.2020.01.01

38. Patel, H., Malawade, M., Butte-Patil, S., Khairnar, P., & Gawade, S. (2017). Comparison of balance in children with and without hearing impairment. International Journal on Biomedicine and Healthcare, 5(5), 19-27.

39. Pavão, S. L., & Rocha, N. A. (2017). Sensory processing disorders in children with cerebral palsy. Infant Behavior and Development, 46, 1-6. https://doi.org/10.1016/j.infbeh.2016.10.007

40. Pavão, S. L., Lima, C. R. G., & Rocha, N. A. C. F. (2021). Association between sensory processing and activity performance in children with cerebral palsy levels I-II on the gross motor function classification system. Brazilian Journal of Physical Therapy, 25(2), 194–202. https://doi.org/10.1016/j.bjpt.2020.05.007

41. Qu, X., Nan, W., Wong, C. M., Wan, F., & Hu, Y. (2015). Reliability and sensitivity analysis on the center of pressure measures in healthy young adults using Nintendo Wii balance board. In 2015 IEEE International Conference on Computational Intelligence and Virtual Environments for Measurement Systems and Applications (CIVEMSA) (pp. 1-4). IEEE.

42. Rojas, V. G., Rebolledo, G. M., Muñoz, E. G., Cortés, N. I., Gaete, C. B., & Delgado, C. M. (2013). Differences in standing balance between patients with diplegic and hemiplegic cerebral palsy. Neural Regeneration Research, 8(26), 2478–2483. https://doi.org/10.3969/j.issn.1673-5374.2013.26.009

43. Sukal-Moulton, T., Gaebler-Spira, D., & Krosschell, K. J. (2018). The validity and reliability of the Test of Arm Selective Control for children with cerebral palsy: a prospective cross-sectional study. Developmental Medicine and Child Neurology, 60(4), 374–381. https://doi.org/10.1111/dmcn.13671

44. Vuong, A., Fowler, E. G., Matsumoto, J., Staudt, L. A., Yokota, H., & Joshi, S. H. (2021). Selective Motor Control is a Clinical Correlate of Brain Motor Tract Impairment in Children with Spastic Bilateral Cerebral Palsy. AJNR. American Journal of Neuroradiology, 42(11), 2054–2061. https://doi.org/10.3174/ajnr.A7272

45. Yassin, O. S., Elshafey, M. O., Hamdy, B., Gamal, R., & Abdelazeim, F. (2020). Comprehensive evaluation of vestibular dysfunction in deaf children. Journal of Critical Reviews, 7, 3589-3594. https://www.researchgate.net/publication/348540578

46. Yu, Y., Tucker, C. A., Lauer, R. T., & Keshner, E. A. (2020). Influence of Visual Dependence on Inter-Segmental Coordination during Upright Stance in Cerebral Palsy. Journal of Motor Behavior, 52(3), 249–261. https://doi.org/10.1080/00222895.2019.1610860

47. Zarkou, A., Lee, S. C. K., Prosser, L. A., & Jeka, J. J. (2020). Foot and Ankle Somatosensory Deficits Affect Balance and Motor Function in Children with Cerebral Palsy. Frontiers in Human Neuroscience, 14, 1-12. https://doi.org/10.3389/fnhum.2020.00045

48. Zhou, J. Y., Lowe, E., Cahill-Rowley, K., Mahtani, G. B., Young, J. L., & Rose, J. (2019). Influence of impaired selective motor control on gait in children with cerebral palsy. Journal of Children's Orthopaedics, 13(1), 73–81. https://doi.org/10.1302/1863-2548.13.180013

Downloads

Published

30-10-2026

How to Cite

Fathi Fouad, R., Reffat , S. M., & El Shemy, S. A. (2026). Sensory processing abilities, postural stability, and selective motor control in children with hemiplegic cerebral palsy: a cross-sectional study. SPORT TK-EuroAmerican Journal of Sport Sciences, 15, 102. https://doi.org/10.68574/sportk.381

Issue

Vol. 15 (2026)

Section

Articles

License

Copyright (c) 2026 Reham Fathi Fouad, Shimaa Mohamed Reffat , Samah Attia El Shemy

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © by the authors. This is an open-access article distributed under the terms of the Creative Commons CC BY 4.0 license, meaning that anyone may download and read the paper for free. The use, distribution or reproduction in other forums is permitted, provided the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. These conditions allow for maximum use and exposure of the work, while ensuring that the authors receive proper credit.