Abstract
Anticipatory postural adjustments (APAs) play an important role in the performance of many activities requiring the maintenance of standing posture. However, little is known about if and how children with cerebral palsy (CP) generate APAs. Two groups of children with CP (hemiplegia and diplegia) and a group of children with typical motor development performed arm flexion and extension movements while standing on a force platform. Electromyographic activity of six trunk and leg muscles and displacement of center of pressure (COP) were recorded. Children with CP were able to generate anticipatory postural adjustments and produce directionally specific APAs and COP displacements similar to those described in adults and typically developing children. However, children with diplegia were unable to generate APAs of the same magnitude as children with typical development and hemiplegia and had higher baseline muscle activity prior to movement. In children with diplegia, COP was posteriorly displaced and peak acceleration was smaller during bilateral extension compared to children with hemiplegia. The outcomes of the study highlight the role of APAs in the control of posture of children with CP and point out the similarities and differences in anticipatory control in children with diplegia and hemiplegia. These differences may foster ideas for treatment strategies to enhance APAs in children with CP.
Highlights
Cerebral palsy (CP), a neurodevelopmental condition caused by a non-progressive brain lesion, can occur before, during or shortly after birth (Bax et al 2005; Rosenbaum 2007)
There was no significant difference in peak acceleration among the three groups of children for FLEX
EMG Activity EMG traces of the right and left trunk and upper leg muscles for a representative child from each group are presented in Figures 2 and 3
Summary
Cerebral palsy (CP), a neurodevelopmental condition caused by a non-progressive brain lesion, can occur before, during or shortly after birth (Bax et al 2005; Rosenbaum 2007). Children diagnosed with CP demonstrate increased muscle activity to sustain posture, agonist/antagonist co-contraction, impaired postural control, inadequate force production, and restricted voluntary and selective control of movement (Campbell 1991; Damiano et al 2001; Olney and Wright 2006; Prosser et al 2010). These impairments interfere with performance of functional activities, and with opportunities and/or willingness to participate in leisure, community and school activities (Roncesvalles et al 2002; Olney and Wright 2006). This study provided the stimulus for research describing the development of CPAs in infants and children (Brogren et al 1996; Hadders-Algra et al 1998; Woollacott et al 1998; van der Heide et al 2004)
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