Postural alignment in children with bilateral spastic cerebral palsy using a bimanual interface for powered wheelchair control

Objective: To examine postural alignment in children with bilateral spastic cerebral palsy while driving a powered wheelchair using both a unilateral joystick and an innovative bimanual interface. Design: Cross-sectional study. Subjects: A total of 20 children with bilateral spastic cerebral palsy (mean age 9.0 years (standard deviation 2.1); 11 with diplegia, 9 with quadriplegia) and 14 typically developing children (mean age 7.7 years (standard deviation 2.9)). Methods: All children drove the powered wheelchair in both the unilateral and bimanual conditions. The Seated Postural Control Measure quantified the postural alignment of subjects while driving the powered wheelchair. Statistical analysis was carried out using repeated measures analysis of variance and Spearman's rank correlation coefficient. Results: As expected, typically developing children had better postural alignment in both driving conditions than children with cerebral palsy. Children with cerebral palsy demonstrated more symmetrical postural alignment while using the bimanual interface than when using the unilateral joystick. In addition, the severity of cerebral palsy correlated moderately with postural symmetry in both conditions. Conclusion: The results suggest that this innovative bimanual interface might be beneficial for promoting symmetrical postural alignment in some children with bilateral spastic cerebral palsy.