must tools used in rehabilitation be reliable and valid, but
they must also be appropriate for clinical use. Tools that are
prohibitively expensive, time-consuming, or require laboratory
testing have little clinical use. In addition, tools used
in rehabilitation must be sensitive enough to detect clinically
important changes in function.
Children with cerebral palsy experience muscle coordination
problems, difficulties with the organization of
sensory information and functional limitations that may be
influenced by increased tone in their upper and lower extremities.
These factors affect postural control.2 Balance
strategies of children with cerebral palsy are different than
the strategies used by children without a neurological impairment.
Children with cerebral palsy demonstrate increased
co-contractions of distal and proximal muscles and
do not have a smooth distal-to-proximal pattern of muscle
activation.3 Nashner et al.4 found that, unlike subjects developing
typically, children with cerebral palsy demonstrated
a reversed order of activation of distal and proximal
muscle synergies in response to a moving platform. In children
with spastic hemiplegia, Nashner et al.4 also found
must tools used in rehabilitation be reliable and valid, butthey must also be appropriate for clinical use. Tools that areprohibitively expensive, time-consuming, or require laboratorytesting have little clinical use. In addition, tools usedin rehabilitation must be sensitive enough to detect clinicallyimportant changes in function.Children with cerebral palsy experience muscle coordinationproblems, difficulties with the organization ofsensory information and functional limitations that may beinfluenced by increased tone in their upper and lower extremities.These factors affect postural control.2 Balancestrategies of children with cerebral palsy are different thanthe strategies used by children without a neurological impairment.Children with cerebral palsy demonstrate increasedco-contractions of distal and proximal muscles anddo not have a smooth distal-to-proximal pattern of muscleactivation.3 Nashner et al.4 found that, unlike subjects developingtypically, children with cerebral palsy demonstrateda reversed order of activation of distal and proximalmuscle synergies in response to a moving platform. In childrenwith spastic hemiplegia, Nashner et al.4 also found
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