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

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.

• Body position
• cerebral palsy
• children
• physical activity
• posture