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Disabil Rehabil. 2013 Sep 11. [Epub ahead of print]

Monitoring of body position and motion in children with severe cerebral palsy for 24 hours.

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  • 1Department of Rehabilitation, Kitasato University School of Allied Health Sciences , Sagamihara , Japan .


Abstract Purpose: To investigate differences in position and body movements between children with severe cerebral palsy (CP) and children with typical development (TD) during the daytime and while asleep at night. Method: Fifteen children with severe quadriplegic CP living at home (GMFCS level V, 7 males, 8 females; mean age 8 years 3 months; range 3-20 years) and 15 children with TD (6 males, 9 females; mean age 8 years 7 months; range 1-16 years) participated. Body position and movements were recorded for 24 h by a body position monitor and a physical activity monitor, respectively. The amount of time spent in one position and the durations of inactive periods during the daytime and during night-time sleep were computed and analyzed for group differences. Results: In children with CP, the mean longest time spent in one position was longer than that in children with TD during night-time sleep (5.6 ± 3.5 h versus 1.6 ± 1.2 h). In contrast, no significant differences were found between the groups during the daytime (1.9 ± 1.1 h versus 1.6 ± 0.7 h). The mean longest time the body remained inactive was longer in the children with CP during both daytime and nighttime sleep (0.6 ± 0.3 h versus 0.3 ± 0.3 h for daytime, 1.4 ± 0.8 h versus 0.7 ± 0.3 h for nighttime). Conclusion: Children with severe CP living at home showed prolonged immobilized posture during night-time sleep when their caregivers would be likely to also be asleep. This may suggest that these children should receive postural care assistance at night. Implications for Rehabilitation A large number of daytime position changes are seen in children with severe cerebral palsy (CP), even if they are unable to change positions by themselves. One position is held with no movement during night-time sleep in children with severe CP. Prolonged immobility posture during night-time sleep might suggest the need for postural care assistance at night for these children.

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