The reliability of the photographic posture analysis during sitting in children with cerebral palsy and the relationship between the trunk control and the motor functions

The aim of this study was to analyze the reliability of photographic posture analysis (PPA) in sitting position in children with spastic CP, and to examine the relationship between PPA and motor performance and trunk control in children with cerebral palsy (CP). Sixty-five children with CP between the ages 5-12 who were diagnosed with hemiparetic and diparetic SP at the level of 1, 2 and 3 according to Gross Motor Function Classification (GMFCS) were evaluated with PPA in a sitting position. To evaluate the reliability of photographic posture analysis, measurements were made by two researchers at one-day intervals. Trunk control of children was evaluated using the Trunk Control Measurement Scale (TCMS), and motor functions were measured by Gross Motor Function Measurement (GMFM). Craniovertebral angle, sagittal head tilt, sagittal shoulder and C7 angle, coronal head tilt, coronal shoulder angle, thoracic kyphosis angle, lumbal lord angle, coronal pelvis tilt angles were found to have high reliability between intra and interater observers (ICC> 0.9). Moderate positive significant correlation was found between TCMS total score and sagittal head tilt (r =0.270), sagittal shoulder and C7 angle (r =0.255). Moderately negative significant correlation was found between TCMS total score and coronal head tilt (r =-0.442) and coronal pelvis angle (r =-0.454) A moderate positive significant correlation was found between the total score of GMFM and the sagittal shoulder and C7 angle (r =0.297). There was a moderate negative significant correlation between coronal head tilt (r =-0,363) and coronal shoulder angle (r =-0,268). There was a strong negative correlation between the coronal pelvis angle (r = -0.535) (p<0.05). As a result, PPA is a reliable scale that evaluates posture in sitting position in children with CP and is suitable for use in clinics. Increasing the forward tilt of the head, the protraction of the shoulder, asymmetry of the head and pelvis in the sitting posture in SP causes decreased body control and motor functions. Physiotherapists should pay attention to the postural alignment in the pelvis, head and shoulder girdle to clinically improve trunk control and functional activities.