The results suggest that, in terms of postural control and quality of reaching, children with unilateral spastic CP benefit from a forward-tilted position and children with bilateral spastic CP benefit from a horizontal sitting position.
We evaluated the development of postural adjustments accompanying reaching movements in sitting children. Twenty-nine typically developing children aged, 2-11 years, and ten adults were studied with multiple surface electromyograms (EMGs) and kinematics during reaching in four conditions: sitting with the seat-surface oriented horizontally with and without an additional task load, and sitting with the seat-surface tilted 15 degrees forward and 15 degrees backward. The development of postural adjustments during reaching in a sitting position turned out to have a non-linear and protracted course, which is not finished by the age of 11 years. The development of these adjustments is characterised by variation, yet specific developmental sequences could be distinguished. Firstly, the development of postural adjustments during reaching from the age of 2 years onwards lacked a preference for an en bloc strategy, which consists of an in concert activation of the direction-specific neck and trunk muscles. Secondly, anticipatory postural muscle activity, which was consistently present in adults, was virtually absent between 2 and 11 years of age. Thirdly, the data demonstrated that with increasing age the head gradually becomes the dominant frame of reference. In addition, the study suggested that, in terms of postural control, the forward-tilted position is the most efficient one.
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