Sensorimotor Control During Postural Transitions in CP

Inclusion Criteria for individuals with CP:

1. Age 10-21

2. Diagnosis of CP

3. GMFCS level I-II

4. Ability to stand up from a chair and start walking.

5. Migration index of proximal hip (MIGR) < 40% femoral head covering in acetabulum

6. At least 0° passive dorsiflexion range of motion (ROM)

7. Sufficient visuoperceptual, cognitive and communication skills

8. Seizure-free or well-controlled seizures

9. No other neurological or musculoskeletal disorders (e.g. dystonia, severe scoliosis, hip instability

10. Ability to communicate pain or discomfort

11. Ability to assent/consent or obtain parent/guardian consent

Exclusion Criteria for individuals with CP:

1. Scoliosis with primary curve > 40%

2. Spinal fusions extending into pelvis

3. Lower Extremity joint instability or dislocation

4. Severe tactile hypersensitivity

5. Lower extremity botulinum injections in the past 6 months

6. Implanted medical device or metal contraindicative of the application of SR

7. Pregnancy (self-reported)

8. Severe lower extremity spasticity (Modified Ashworth Scale score of 4 or greater)

9. History of pulmonary disease limiting exercise tolerance (Asthma Control Test screen)

10. History of cardiac disease (American Heart Association screen)

11. Severely limited range of joint motion/ irreversible muscle contractures

12. Lower extremity surgery or significant injury within last 1 yr.

Inclusionary criteria for typically developing volunteers:

1. Aged 10-21 years old

2. Ability to stand up from a chair and start walking without an assistive device or orthoses

3. Able to communicate discomfort during testing and can follow multi-step directions

4. Has not been diagnosed with any neurological or balance disorders

5. Seizure-free

Exclusionary criteria for typically developing volunteers:

1. Diagnosis of CP

2. Significant scoliosis with primary curve > 40°

3. Lower extremity surgery or fractures in the year prior testing

4. Joint instability or dislocation in the lower extremities

5. Severe tactile hypersensitivity

6. A history of selective dorsal root rhizotomy

7. Botulinum toxin injections in the lower extremities within the past 6 months

8. Marked visual or hearing deficits

9. Any embedded metal that may be contraindicated with application of SR

10. Severe spasticity of the lower extremity muscles (eg. a score of 4 on the Modified Ashworth)

11. Pregnancy (self-reported)

12. Severely limited joint range of motion/ irreversible muscle contractures that would not be candidates for soft-tissue surgery

13. Learning disabilities

14. History of neurological disorders

15. Balance and/or postural impairment