Eye movements and postural alignment in children with cerebral palsy

dc.contributor.advisorVan Heerden, S. M.
dc.contributor.advisorVisser, M.
dc.contributor.authorScholtz, Christina Elizabeth
dc.contributor.otherEllis, S. M.
dc.date.accessioned2015-11-06T09:10:28Z
dc.date.available2015-11-06T09:10:28Z
dc.date.copyright2013-06
dc.date.issued2013-06
dc.date.submitted2013-06
dc.description.abstractEnglish: The level of severity of disability may have increased among children with cerebral palsy and therefore continued monitoring of the characteristics of children with cerebral palsy is necessary. Cerebral palsy (CP) can be considered as a sensory-motor disorder that results from malformations in the developing brain that disrupts the development of the neuronal network and cortical and sub-cortical pathways. Although the motor behaviours and postural deficits are defining features of CP, visual disorders are a main symptom in the clinical picture of CP. There are well sounded reasons why children with CP have difficulties to partake in everyday activities. Neurologic pathology can affect specific aspects of postural control including the ability to maintain stability with alignment in a specific position. Postural control is necessary for maintaining all body segments in an upright position and to orientate the eyes to the environment. Problems with the visual system in CP include peripheral problems related to the anterior part of the visual system, visual problems of central origin and cerebral visual impairment. Observations of eye movements and postural alignment in sitting in children with CP were the focus of this study. These are variables known to potentially influence occupational-based activities. The aim of the study was to describe eye movements and postural alignment and to investigate if there was a possible association between eye movements and postural alignment in sitting in a frontal plane of children with CP, between the age of two and ten years. A non-experimental, quantitative approach addressed the aim. A descriptive study was used to describe the eye movements and alignment in body segments over the base of support against gravity. A correlation study was used to investigate the possible association between postural alignment and eye movements in children with CP. Following the pilot study the unstructured and structured observations were administered to a convenience sample of children with CP attending a clinic, school or a private practice. Fifty seven children with CP, between two and ten years of age participated in the study after meeting the pre-determined inclusion criteria. The data collected were numbers that reflected specific measurements of the characteristics in question and were analysed by using a grounded, observed – clinical reasoning approach. The mean age of the children was 5.3 years (SD = 2.26). Discussion of results was directed at describing eye movements and postural alignment and interpreting the implications of those associations for clinical practice. The obtained data from the unstructured and structured observations were statistically analysed and compared and did produce a statistically significant positive association between eye movements and postural alignment therefore, both the posture and the eye movements are critical to the provision of intervention. The study confirms the association between eye movements and postural alignment in sitting in children with CP. This study has documented the difficulties the child with CP has to encounter. This may facilitate the establishment of effective and appropriate measuring instruments for occupational therapists, assessing functional vision and postural alignment in any setting of practice.en_ZA
dc.description.abstractAfrikaans: Die erns van simptome van gestremdheid neem toe onder kinders met serebrale gestremdheid en die voortgesette monitering van die eienskappe van kinders met serebrale gestremdheid is nodig. Serebrale gestremdheid (SG) kan beskou word as ’n sensories-motoriese disfunksie wat voortspruit uit misvormdhede in die ontwikkelende brein wat die ontwikkeling van neurale netwerke en kortikale en subkortikale bane versteur. Alhoewel die motoriese gedrag en postuurtekorte ’n definiërende eienskap van SG is, is visuele disfunksies ’n primêre simptoom van die kliniese beeld van SG. Daar bestaan weldeurdagte redes waarom kinders met SG dit moeilik vind om aan alledaagse aktiwiteite deel te neem. Neurologiese patologie kan spesifieke aspekte van postuurbeheer affekteer, insluitende die vermoë om stabiliteit in ’n spesifieke posisie te handhaaf. Postuurbeheer is nodig vir die handhawing van alle liggaamsegmente in ’n regop posisie en om die oë ten opsigte van die omgewing te oriënteer. Probleme met die visuele sisteem in SG sluit periferale probleme met betrekking tot die voorkant van die visuele sisteem, visuele probleme van sentrale oorsprong en serebraal-visuele inkorting in. Waarnemings rakende oogbeweging, postuurbelyning in ’n sittende posisie en oogbeweging by kinders met SG was die fokus van hierdie studie. Dit is bekend dat hierdie veranderlikes potensieel beroepsgebaseerde aktiwiteite beïnvloed. Die doel van die studie was om oogbewegings en postuurbelyning te beskryf en ondersoek in te stel of daar ’n moontlike assosiasie tussen oogbewegings en postuurbelyning in ’n vooraansig by kinders met SG in ’n sittende posisie tussen die ouderdom van twee en tien jaar is. ’n Nie-eksperimentele, kwantitatiewe benadering het die doelwit aangespreek. ’n Beskrywende studie is gebruik om die oogbewegings en postuurbelyning in liggaamsegmente oor die steunbasis teen swaartekrag te beskryf. ’n Korrelasiestudie is gebruik om die moontlike assosiasie tussen postuurbelyning en oogbewegings by kinders met SG te ondersoek. Na afloop van die loodsstudie is die ongestruktureerde en gestruktureerde waarnemings op ’n gerieflikheidsteekproef van kinders met SG wat ’n kliniek, skool of private praktyk besoek, gedoen. Sewe-en-vyftig kinders met SG tussen die ouderdom van twee en tien jaar het aan die studie deelgeneem, nadat hulle aan die voorafbepaalde insluitingskriteria voldoen het. Die data wat versamel is, is getalle wat spesifieke metings van die eienskappe in die vrae weerspieël en geanaliseer is deur van ’n begronde, waargenome, kliniese beredeneringsbenadering gebruik te maak. Die gemiddelde ouderdom van die kinders was 5,3 jaar (SD = 2.26). Die bespreking van die resultate was daarop gemik om oogbewegings en postuurbelyning te beskryf en die implikasies van daardie assosiasies vir die kliniese praktyk te vertolk. Die data wat uit die gestruktureerde waarnemings verkry is, is statisties ontleed en vergelyk en het ’n statisties betekenisvolle positiewe verband tussen oogbewegings en postuurbelyning aangetoon. Gevolglik is beide die postuur- en oogbewegings krities wat betref enige intervensie. Die studie bevestig die assosiasie tussen oogbewegings en postuurbelyning by kinders met SG in ’n sittende posisie. Hierdie studie het die probleme gedokumenteer waarmee ’n kind met SG gekonfronteer word. Dit kan die vestiging van doeltreffende en geskikte meetinstrumente vir arbeidsterapeute fasiliteer wat funksionele visie en postuurbelyning in enige omgewing kan assesseer.af
dc.identifier.urihttp://hdl.handle.net/11660/1505
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA
dc.subjectParticipationen_ZA
dc.subjectOccupational-based activitiesen_ZA
dc.subjectVisual dysfunctionen_ZA
dc.subjectVisual pathwaysen_ZA
dc.subjectCerebral visual impairmenten_ZA
dc.subjectFunctional visionen_ZA
dc.subjectPostural controlen_ZA
dc.subjectEye movementsen_ZA
dc.subjectPostural alignmenten_ZA
dc.subjectCerebral palsyen_ZA
dc.subjectCerebral palsied childrenen_ZA
dc.subjectVision disorders in childrenen_ZA
dc.subjectPosture disorders in childrenen_ZA
dc.subjectOccupational therapy for childrenen_ZA
dc.subjectDissertation (M.Occupational Therapy (Occupational Therapy)-- University of the Free State, 2013en_ZA
dc.titleEye movements and postural alignment in children with cerebral palsyen_ZA
dc.typeDissertationen_ZA
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