Postural Control in Children with Diplegic Cerebral Palsy: The Association with Cervical Joint Position Sense Error.

This cross-sectional study aimed to investigate relationship between postural control and cervical joint position sense error (CJPSE) in children with spastic diplegic cerebral palsy (CP). Thirty-eight children with spastic diplegic CP (Gross Motor Function Classification System levels I-III), aged 5-12 years (mean age 7.94 ± 2.87), participated in study. CJPSE was evaluated using Cervical Range of Motion (CROM) device in flexion, extension, right/left rotation, and right/left lateral flexion directions. Postural control was assessed with Trunk Control Measurement Scale (TCMS), and gross motor function was measured by Gross Motor Function Measure-66 (GMFM-66). Correlations between variables were analyzed using Spearman's rank correlation test. Cervical joint position error was negatively correlated with postural control for flexion (r= -0.533, p = 0.001), extension (r= -0.413, p = 0.011), left rotation (r= -0.702, p < 0.001), and lateral flexion (r= -0.660/-0.736, p < 0.001), while right rotation showed small positive correlation (r = 0.350, p = 0.034). Strongest relationships appeared in dynamic sitting subscale of TCMS. Gross motor function was inversely associated with CJPSE error in flexion, left rotation, and lateral flexion movements, particularly in GMFM-C and GMFM-E dimensions. Impaired CJPSE is closely linked to lower postural control and gross motor performance in children with spastic diplegic CP. Incorporating CJPSE evaluation into rehabilitation may enhance functional outcomes.