Effect of the severity of manual impairment and hand dominance on anticipatory and compensatory postural adjustments during manual reaching in children with cerebral palsy

Aim: To investigate the role of the severity of manual impairment and of hand dominance on postural sway during anticipatory {[}APA] and compensatory {[}CPA] postural adjustments in a seated manual reaching task performed by children with cerebral palsy (CP) and typical children (TC). Methods: We tested 26 TC (mean age 9.5 +/- 2.1 years) and 29 children with CP (age 9.6 +/- 3 years) classified based on manual impairment levels as mild (Manual Ability Classification System {[}MACS] I; n = 18) or moderate-to-severe (MACS n = 11). Participants were instructed to reach towards a target using their dominant vs. non -dominant arm while sitting on a force-plate. Center of pressure (CoP) sway was analyzed during APA and CPA. Results: For all groups, using the non-dominant arm determined greater amplitude and velocity of CoP sway in CPA. Children with moderate-to-severe manual impairment showed greater sway during APA and CPA compared to mild impairment and TC groups. Conclusion: More severe manual impairment resulted in higher sway during the anticipatory and compensatory phases of the reaching task. Using the non -dominant arm resulted in greater compensatory adjustments during reaching. (AU)