Abstract :
Background: School going children in the age group of 7-12 years have to spend long hours in sitting,
and maintain adequate balance in order to use their upper limbs efficiently and functionally during play and
in the performance of Activities of Daily Living (ADLs). Studies that have examined trunk control and the
effect of underlying muscle tightness and spasticity that cause biomechanical constraints in children with
Cerebral Palsy (CP) is scarce.
Aim: This study aims to assess the effect of Hamstring muscle tightness on Sitting Balance in children
with CP spastic diplegia.
Materials and Methods: Thirty (30) children with CP spastic diplegia (n=30) belonging to GMFCS
Levels I, II, and III, in the age group of 7-12 years, and thirty (30) age and sex-matched typically
developing(TD) children were recruited for this study. Hamstring tightness was assessed by calculating the
R2 angle using the modified tardieu scale. Pelvic tilt was measured in sitting using the pelvic inclinometer
and sitting balance by Paediatric reach test & Trunk control measurement scale (TCMS). Centre of pressure
excursion in forwarding direction was measured using the limits of stability protocol in sitting on the
neurocom balance Master.
Results: Children with CP spastic diplegia sat with a greater posterior pelvic tilt compared to TD children
(p tilt in both groups of children (r value=0.6, p hamstrings spasticity with reach in forward as well as lateral directions (r value= 0.5, p tilt with reach in forward and lateral directions (r value = 0.6, p TCMS scores showed a moderate negative correlation with hamstrings tightness and posterior pelvic tilt
(rho = 0.6). The maximum excursion of limits of stability showed a moderate negative correlation with
hamstrings tightness and posterior pelvic tilt in the forward directions.
Conclusion: Greater tightness of the hamstring muscles was associated with a posterior pelvic tilt and
reduced sitting balance. Therapeutic interventions that manage hamstring muscle tightness may improve
the alignment of pelvis over the hip and or the trunk over the pelvis, resulting in an improvement in sitting
balance in CP children with diplegia.
Keyword :
Cerebral palsy, Spastic diplegia, Hamstring tightness, Sitting balance, Trunk control.