All ETDs from UAB

Advisory Committee Chair

Jennifer B Christy

Advisory Committee Members

Claudio Busittini

Richard D Davis

Laura Vogtle

Kathrine Weise

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Cerebral palsy (CP) is the most common motor disability of childhood, caused by non-progressive permanent injury to the fetal or infant’s brain. Visual and balance impairments are prominent hallmarks of these disorders. Although musculoskeletal and neuromuscular causes are well established in the literature, the role of vestibular and oculomotor disabilities was not explored in this population. Because of that, this dissertation aims to describe the vestibular and oculomotor function in children with CP, aged 7-12years, GMFCS levels I-III, and to determine the feasibility, sensitivity, specificity and retest reliability of vestibular and oculomotor clinical tests in children with CP, compared to an age and gender matched group of children with typical development (TD). This pursuit resulted in four studies. The first study was a scoping review focused on exploring the extent of literature examining vestibular and oculomotor function in children with CP. Twenty-one articles were identified, which showed that children with CP had altered oculomotor function (n=9), abnormal saccular function (n=1), poor eye-hand coordination and abnormal use of vestibular information for balance (n=11); it also showed that there is need for a full description of the vestibular and oculomotor function in children with CP. The second and third studies evaluated peripheral and central vestibular and oculomotor function in children with CP using high-tech laboratory tests. The results of these two studies showed that children with CP have evidence of central vestibular dysfunction. For horizontal and vertical smooth pursuit, children with CP were unable to match the velocity of the target. The saccadic dynamics of most children with CP was similar to their TD peers and we did not find a common variable (e.g. GMFCS, type of CP) among the CP children with abnormal saccadic dynamics. Study four examines a battery of vestibular and oculomotor clinical tests. The results showed that this battery was feasible and reliable in children with CP and sufficiently sensitive to rule out evidence of central vestibular dysfunction. In summary, children with CP presented evidence of central vestibular dysfunction and clinical tests may be useful to guide assessment and intervention focus.

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