Development of postural adjustments during reaching in infants with CP

Abstract

The development of postural adjustments during reaching movements was longitudinally studied in seven infants with cerebral palsy (CP) between 4 and 18 months of age. Five infants developed spastic hemiplegia, one spastic tetraplegia, and one spastic tetraplegia with athetosis. Each assessment consisted of a simultaneous recording of video data and surface EMGs of arm, neck, trunk, and leg muscles during reaching in various lying and sitting positions. The basic organization of postural adjustments of the children developing spastic CP was intact. Their main problem was a deficient capacity to modulate the postural adjustments to task‐specific constraints ‐ a deficit which was attributed to a combination of an impaired motor coordination and deficits in sensory integration. The child with spastic‐dyskinetic CP showed distinct abnormalities in the basic organization of postural adjustments.

Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: a pilot study

“…Research on skill development in children with cerebral palsy (CP) has documented constraints in the performance of voluntary skills, including manipulatory and mobility skills. These limitations are accompanied by underlying constraints in postural function (Nashner et al 1983;Brogren et al 1996Brogren et al , 1998Burtner et al 1998;Hadders-Algra et al 1999). Constraints in locomotor and postural skills include delays in the onset of independent standing and walking, poor levels of performance of these tasks, or an inability to stand and walk, depending on the severity of the disorder (Crothers and Paine 1988).…”

Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities

“…We suggest that fine-tuning of muscle activation levels is likely to be involved in this stabilization capability, since reduced contractile potential of more distal muscles has been reported as a primary deficit in individuals with CP ( Barela and Almeida 2006;Mackey et al 2006;Jaspers et al 2011;Klingels et al 2012). Such reduced capability of children with CP to fine-tune muscular activation according to task demands has already been noted in the context of postural tasks (Hadders-Algra et al 1999). In this light, the differences in performance between groups in the present study were larger in the most challenging experimental condition because the capability/demand relation relevant for task performance was more dissimilar between groups than in the least challenging condition.…”

Functional reaching discloses perceptive impairment in diplegic children with cerebral palsy

“…Complex PAs are exhibited by Typically Developing (TD) children from the age of 4 months [11]. For TD, experience and selflearning activities play a key role in fine-tuning modulation of muscle contraction during postural adjustments [11] resulting in a variable recruitment of the direction-specific muscles [13].…”

“…Complex PAs are exhibited by Typically Developing (TD) children from the age of 4 months [11]. For TD, experience and selflearning activities play a key role in fine-tuning modulation of muscle contraction during postural adjustments [11] resulting in a variable recruitment of the direction-specific muscles [13]. Conversely to TD, diplegic CP children (i) use proximal to distal muscle recruitment strategy [13,16,18], (ii) show a reduced capacity in fine-tuning their PAs to task specific conditions [19,20], (iii) usually perform jerky movements [21], and (iv) present stereotyped and direction-inappropriate muscular activities [19,22] more pronounced in diplegic rather than hemiplegic children [14].…”

“…Besides walking, the reaching task is one of the most studied tests to assess the motor and perceptive disorders in CP children [11][12][13]. In particular, reaching from a sitting position, is used to investigate the postural control ability and it strongly deals with the development of independent life skills [14].…”