Åsa Bartonek

My research focuses on children with motor disabilities. Many children present with a combination of orthopaedic, neurological, and cognitive aspects, making it a significant challenge to identify which factors are most decisive for the child’s motor development and gait.

The following provides a brief insight into the perspectives that have guided my research over the years:

In terms of motor development and walking ability, many children born with myelomeningocele are often managed within orthopaedics. Since this condition involves malformations of the spinal cord and brain, it may lead to balance impairments and fear of movement, which can affect function yet more than the consequences of the muscle pareses by the spinal lesion itself.

Similarly, a child with cerebral palsy whose primary limitations are motor can benefit from orthopaedic interventions to improve walking ability. In contrast, another child may present with significant cognitive challenges affecting movement perception and spatial processing, resulting in limited walking function despite relatively mild motor impairment. Identifying which aspects of the sensorimotor system are most affected is therefore crucial, as the “sense of movement” depends on varying contributions from vision, proprioception, vestibular function, and other factors depending on the task and environment. The group of children with multiple joint contractures and amyoplasia primarily falls within orthopaedics, where the goal is often to achieve symmetry between body sides. However, certain forms of arthrogryposis may also involve central nervous system dysfunction, which can influence goals related to walking ability. 

To better understand children’s ability to navigate their surroundings, I have also studied topographic working memory during walking tasks, as well as visuospatial working memory during reaching tasks.

Across diagnostic groups, many children require orthoses. Over time, our understanding has deepened regarding what it means for a child to integrate an external device into their body schema. One current area of research involves the development of a self-reported questionnaire for children, aimed at strengthening their voice and perspective.

Overall, biomechanical methods have been used to study gait patterns and forces affecting movement in several patient groups. In patients with congenital lower limb deficiencies, 3D gait analysis has been useful to describe gait with both orthotic and prostethic devices. Biomechanics has also been applied to understand children’s sensorimotor strategies, such as their ability to adapt walking speed.

In addition to quantitative methods, emphasis has also been placed on health status and perceived pain, to better understand children’s compensatory strategies.

Finally, retrospective studies have provided valuable knowledge from following the same individuals into adulthood.