A Comparison of Interventions for Children With Cerebral Palsy to Improve Sitting Postural Control: A Clinical Trial

BACKGROUND: The ability to sit independently is fundamental for function but delayed in infants with cerebral palsy (CP). Studies of interventions directed specifically toward sitting in infants with CP have not been reported. OBJECTIVE: The purpose of this study was to compare 2 interventions for improving sitting postural control in infants with CP. DESIGN: For this randomized longitudinal study, infants under 2 years of age and at risk for CP were recruited for intervention directed toward sitting independence. SETTING: The intervention was conducted at home or at an outpatient facility. PATIENTS AND INTERVENTION: Fifteen infants with typical development (mean age at entry = 5 months, SD = 0.5) were followed longitudinally as a comparison for postural variables. Thirty-five infants with delays in achieving sitting were recruited. Infants with delays were randomly assigned to receive a home program (1 time per week for 8 weeks; mean age = 15.5 months, SD = 7) or a perceptual-motor intervention (2 times per week for 8 weeks; mean age = 14.3 months, SD = 3). MEASUREMENTS: The primary outcome measure was center-of-pressure (COP) data, from which linear and nonlinear variables were extracted. The Gross Motor Function Measure (GMFM) sitting subsection was the clinical outcome measure. RESULTS: There was a main effect of time for the GMFM sitting subscale and for 2 of the COP variables. Interaction of group × time factors indicated significant differences between intervention groups on 2 COP measures, in favor of the group with perceptual-motor intervention. LIMITATIONS: The small number of infants limits the ability to generalize the findings. CONCLUSIONS: Although both groups made progress on the GMFM, the COP measures indicated an advantage for the group with perceptual-motor intervention. The COP measures appear sensitive for assessment of infant posture control and quantifying intervention response.