Dynamic and static stability in para-athletes with cerebral palsy considering their impairment profile

Abstract

Background: Balance impairment is a common feature in people with cerebral palsy (CP), affecting the performance of daily-life and physical activities.

Objectives: To (1) explore the absolute and relative intrasession reliability of two balance tests to assess dynamic and static balance in ambulant para-athletes with CP; (2) explore the relationships between the two balance tests to determine potential application in sport classification; (3) assess the differences between CP profiles (ie, spastic diplegia, athetosis/ataxia, and spastic hemiplegia) in comparison to those with a minimum impairment; and (4) compare the outcomes of the static and dynamic balance of ambulant para-athletes with CP regarding controls.

Methods: A group of 129 male well-trained para-footballers with CP, classified as Level I according to the Gross Motor Function Classification System, participated in the present study. Static balance was assessed using the One-Leg Stance test, performed bilaterally on a force platform, and the dynamic balance was assessed in two conditions of the Tandem Walk test (TW): walking heel-toe contact over a 5 -m straight line and performing 10 steps.

Results: Moderate-to-excellent intrasession reliability (intraclass correlation coefficient = 0.60-0.98) was obtained for all the measurements and groups. However, only small to moderate correlations were found between the dynamic and the static measurements of balance for the CP group when performing the One-Leg Stance test with the unimpaired or dominant leg (0.23 < r < 0.30; P < .01). The TW performed over 10 steps revealed more sensitivity to discriminate between CP profiles. Those para-athletes with ataxia/athetosis performed worse in all the tests whereas all CP profiles performed worse than the control group (P < .01).

Conclusions: Balance performance and postural control are constrained to a higher extent in those with impaired voluntary control due to ataxia or with involuntary contractions of the muscles due to athetosis.