Is Affected and Unaffected Side Lateral Spinal Mobility Different in Unilateral Cerebral Palsy? A Cross-sectional Study

Abstract

Background: Asymmetric posture is a characteristic feature of unilateral cerebral palsy (UCP). There is limited information on how this postural disturbance affects lateral spinal mobility on the affected and unaffected sides. Objectives: The present study aimed to compare lateral trunk mobility on the affected and unaffected sides in children with UCP. Methods: This cross-sectional study included 60 children with UCP, conducted at Duzce Gokkusagı and Eregli Gokkusagı special education and rehabilitation centers from October 2023 to October 2024. Participants were aged 6 - 18 years and classified as Gross motor function classification system (GMFCS) levels I and II. Two children were excluded due to scoliosis surgery, resulting in a final sample of 58 children. Demographic characteristics such as height, body weight, gender, age, and affected side were recorded. Eligible children, who voluntarily participated, were evaluated by the same examiner. Spinal posture and mobility were assessed in the frontal plane using the spinal mouse (SM) in a standing position. Spinal mobility was evaluated by comparing trunk lateral flexion angles on the affected and unaffected sides. Descriptive statistics were presented as mean and standard deviation for continuous variables and frequency and percentage for categorical variables. The Shapiro-Wilk test was used to assess normal distribution. A dependent sample t-test was performed to compare bilateral lateral spinal mobility, with a significance level set at P < 0.05. Results: Among the children with UCP, 62.9% had right-sided involvement, and 37.1% had left-sided involvement. No significant difference was found between the affected and unaffected side spinal lateral mobility angles of the sacrum-hip (P = 0.353), thoracic (P = 0.602), lumbar (P = 0.079), and inclination (P = 0.352). However, there was a significant difference in sacrum-hip (P = 0.011) and lumbar (P = 0.000) angles in right and left lateral flexion mobility. Conclusions: This study revealed that children with UCP and asymmetric postural patterns have similar lateral spinal mobility on the affected and unaffected sides. However, differences in right and left lateral mobility angles at certain levels were observed, potentially due to the children’s postural patterns. Further research is needed to investigate spinal posture and mobility specific to different postural patterns.