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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2002 December;38(4):219-235

language: English

Visual and motor control disorders in children with cerebral palsy: a proposed guide to evaluate the oculomotor system

Cazzagon M. 1, Olimpi I. 1, Cordaro C. 1, Giammari Aldè G. 2, Pierro M. M. 3

1 IRCCS “Eugenio Medea”, Polo Friuli, Pasian di Prato (Udine)
2 IRCCS “Eugenio Medea”, Bosisio Carini (Lecco)
3 IRCCS “Bambino Gesù” Children Hospital, Roma


The def­i­ni­tion giv­en by ­the Little Club (1959) ­and ­still accept­ed by ­most ­experts of infan­tile cere­bral pal­sy (ICP) stress­es ­the pres­ence of “­non-­motor” dis­or­ders along­side ­motor dis­or­ders in ­this com­plex ­group of syn­dromes. The inter­est of numer­ous research­ers ­and schol­ars ­has ­long ­been con­cen­trat­ed on ­the ­non-­motor dis­or­ders. This ­has ­been moti­vat­ed by ­the evi­dence ­that, fre­quent­ly, ­the “­non-­motor” dis­or­ders (sen­so­ry, per­cep­tive, per­cep­tive-­motor, prax­o­log­i­cal, gnos­tic or con­cep­tu­al dis­or­ders) con­di­tion ­the prog­no­sis of ­the ­motor func­tion dis­or­der. The ­most ­recent the­o­ries on ­motor con­trol ­have pro­vid­ed increas­ing­ly sol­id sup­port ­for ­this clin­i­cal evi­dence. Among sen­so­ry dis­or­ders, inter­est ­has in par­tic­u­lar ­been con­cen­trat­ed on dis­or­ders of ­the vis­u­al func­tion, ­which ­are ­very fre­quent in ­ICP. Vision is ­the ­most syn­thet­ic ­and ­the ­most pre­dic­tive ­among ­the impor­tant sourc­es of infor­ma­tion con­cern­ing ­the rela­tion­ship ­between ­the ­body ­and ­objects in ­the envi­ron­ment, ­and it ­plays a lead­ing ­role in ­the acqui­si­tion of ­motor beha­vi­our ­that is adap­tive to chang­es of ­goal ­and of envi­ron­ment. However, it is ­not auton­o­mous in ­this ­task, ­and ­requires inte­gra­tion ­with ves­tib­u­lar ­and exte­ro-pro­pri­o­cep­tive infor­ma­tion to ­enable ­the indi­vid­u­al to ­define per­cep­tive invar­i­ants or con­stants ­that ­enable ­him or ­her to mod­ulate ­the pro­cess of adap­tive mod­ifi­ca­tion of ­motor beha­vi­our. The influ­ence of ­vision on ­motor con­trol is par­tic­u­lar­ly impor­tant dur­ing infan­cy. The ocu­lo­mo­tor ­system, ­through ­the inter­ac­tion of ­its 5 prin­ci­pal ­sub-­systems, pro­vides dynam­ic sta­bil­isa­tion of ­the ­fovea on ­the tar­get ­and ­plays a fun­da­men­tal ­role in gath­er­ing ­and inte­grat­ing vis­u­al infor­ma­tion. Many ­infants ­with ­ICP ­present alter­a­tions of ­the ocu­lo­mo­tor func­tion ­and of com­bined ­eye ­and ­head move­ments. A Guide is pre­sent­ed ­for ­the clin­i­cal-func­tion­al obser­va­tion of ­the mul­ti-mod­ular ocu­lo­mo­tor-­vision ­system.

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