Evaluation of spine alignment and associated factors in children with hemiparetic cerebral palsy

It was aimed to compare children with hemiparetic cerebral palsy (HCP) with those of healthy age by performing frontal and sagittal spinal evaluation and to investigate factors that may affect spinal curvatures, in this study. Twenty-five children with HCP aged from 6-18 years and twenty-five healthy children with the same age range to obtain reference values for Spinal Mouse (SM) measurements were enrolled in the study. Frontal and sagittal plane curvatures of the children were evaluated with SM. In children with HCP, upper limb functions, spatiotemporal gait parameters, anthropometric measurements of upper and lower extremities, pelvic asymetry, scapular winging and weight distributions, muscle strength, muscle tone and body function in sitting position were evaluated. Demographics and physical characteristics of children with HCP and healthy subjects were similar (p>0,05). The mean score of scoliosis angles in all children with HCP was higher than their healthy age (p<0,05), while the mean angles of thoracic kyphosis and lumbar lordosis were similar (p>0,05). In HCP children with scoliosis, step asymmetry ratio was lower, arm and thigh length differences, scapular winging and weight bearing differences between unaffected and affected sides were greater than non-scoliotic HCP children (p<0,05). Children with HCP should be assessed extensively, especially considering the possibility of age-related increase in scoliosis. In children with HCP, it is thought that functional deficiencies, scapular winging and spasticity in the upper extremity, postural control inefficacy in the body and walking problems, spasticity and asymmetry in the lower extremities may be predisposing factors in the development of scoliosis. Knowing these factors will allow children with HCP who are at risk of developing scoliosis to be identified and intervened as early as possible It was concluded that the evaluation of related factors besides scoliosis evaluation by clinical physiotherapists should be considered with a holistic approach.