Assessing Dynamic Balance in Children with Cerebral Palsy

Abstract

Individuals with cerebral palsy routinely suffer from dynamic balance deficits during gait that affect their safety and mobility. Although balance can be expected to improve throughout childhood and adolescence for most patients, this improvement levels off or even reverses in adulthood due to orthopedic reasons or the decrease in physical activity seen in many adults. Fortunately, there exist many effective therapies which can improve balance regardless of age. These include a number of strength and vestibular training methods as well as some innovative therapies involving virtual reality, vibration, and electrical stimulation. Key to judging the success of an intervention is the method of balance assessment used, and these range from semi-qualitative task-oriented and functional tests that require few resources to quantitative and instrumented that require a full gait laboratory and staff. This chapter discusses the natural history of balance deficits in individuals with cerebral palsy, the methods by which balance is assessed, and, finally, the interventions used to improve balance including the evidence backing them up.