Investigation of Center of Pressure Displacement During Upper Limb Movements in Children with Neonatal Brachial Plexus Palsy

Phys Occup Ther Pediatr. 2025;45(5):628-638. doi: 10.1080/01942638.2025.2475953. Epub 2025 Mar 10.

Abstract

Aim: The aim of this study was to determine the amount of displacement of the Center of Pressure (CoP) during movement of the affected limb in children with Neonatal Brachial Plexus Palsy (NBPP) and to compare it with the unaffected side.

Method: Forty-six children (6.63 ± 1.97 years) with NBPP who met the inclusion criteria were enrolled in this cross-sectional descriptive study. The amount of CoP displacement was measured using the Bertec BP5046 force plate while performing Modified Mallet Movement Scale (MMMS) subtests.

Results: When performing the MMMS subtests, maximum CoP displacements were greater for movements performed with the affected side (p < 0,05). The CoP displacements at the end of the movement were also greater for the affected side movements for global external rotation, hand to spine, hand to mouth and internal rotation (p < 0,05).

Conclusions: In children with NBPP, the difference in the amount of CoP displacement during the affected and unaffected side movements does not necessarily indicate pathology. It may instead reflect a specific postural control strategy. However, since the difference in the amount of trunk perturbation caused by limb movements can result in an asymmetric loading, it is crucial to include trunk control in rehabilitation protocols.

Keywords: Center of pressure displacement; compensatory movements; neonatal brachial plexus palsy; trunk control.

MeSH terms

  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Movement / physiology
  • Neonatal Brachial Plexus Palsy* / physiopathology
  • Postural Balance* / physiology
  • Pressure
  • Upper Extremity* / physiopathology