Investigation of motor imaging skills in children with spastic cerebral palsy

The purpose of this study was to investigate upper extremity implicit and explicit motor imagery skills in children with cerebral palsy and typically developing children. In our study, aged between 6 and 18 years, 50 children with cerebral palsy (25 unilateral and 25 bilateral) with Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS) grades 1 or 2 and 25 typically developing children were evaluated. Implicit motor imagery skills were assessed with the Recognize App Recognize Hand, hand laterality identification task developed by the NOI group. Explicit motor imagery skills were assessed with mental stopwatch, box block test and Movement Imagery Questionnaire for Children. As outcome of our study, in the results of the box block test, children with unilateral and bilateral cerebral palsy showed similar results on the dominant (p=0.879) and non-dominant (p=0.773) side, while there was a significant difference on both the dominant and non-dominant side (p<0.001) compared to typically developing children. When the individuals with cerebral palsy and the control group were compared in terms of delta time in a simpler task , there was similarity in delta time on the dominant side (p=0.292), whereas on the non-dominant side there was a difference only between unilateral CP and the control group (p=0.020). There was no difference between the dominant side reaction time (p=0.811) and accuracy percentage (p=1.000), nondominant side reaction time (p=0.750) and accuracy percentage (p=1.000) of children with bilateral and unilateral cerebral palsy. Children with CP had worse implicit imagery skills compared to typically developing children (p<0.05). In the Movement Imagery Questionnaire for Children, the groups were similar in terms of external visual imagery and kinesthetic imagery scores (p>0.05), but there was difference between at least two groups in terms of internal visual imagery (0.010) and total score (0.029) (p<0.05). Children with cerebral palsy showed similar results to typically developing children in simple tasks of explicit motor imagery, but showed worse results as the task difficulty increased. The implicit motor imagery skills of children with cerebral palsy were worse than typically developing children. There is no difference between the imagery skills of children with unilateral and bilateral cerebral palsy.