Related Experiment Video
Updated: Aug 16, 2026
Enhancing the Development and Growth of Infant Cerebral Palsy Rats Using Selective Spinal Manipulations
Published on: February 2, 2024
Postural dysfunction in children with cerebral palsy: some implications for therapeutic guidance
Eva Brogren Carlberg1, Mijna Hadders-Algra
1Department of Woman and Child Health, Neuropediatric Research Unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden. eva.brogrencarlberg@chello.se
Insights
Children with cerebral palsy (CP) often struggle with sitting balance due to abnormal muscle activation patterns. Further research is needed to establish evidence-based treatments for improving postural control in these children.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Science
Background:
- Postural problems are central to motor dysfunction in children with cerebral palsy (CP).
- Children with CP often spend more time sitting than standing for daily activities.
- Understanding sitting postural control is crucial for managing CP.
Purpose of the Study:
- To describe the pathophysiology of postural control in sitting for children with CP.
- To outline implications for management and treatment strategies.
- To highlight the need for evidence-based interventions.
Main Methods:
- Review of existing literature on postural control in children with CP.
- Analysis of typical and atypical muscle activation patterns during sitting.
- Discussion of current therapeutic approaches and their limitations.
Main Results:
- Children with CP often exhibit abnormal muscle recruitment (top-down), excessive coactivation, and incomplete EMG adaptation.
- Severe CP cases may lack direction-specific postural adjustments, hindering independent sitting.
- Limited high-level evidence exists for the efficacy of current interventions.
Conclusions:
- Pathophysiology of sitting postural control in CP involves specific muscle activation dysfunctions.
- Current management focuses on adaptive seating and variable training.
- There is a critical need for evidence demonstrating the efficacy of specific treatments to optimize functioning in children with CP.
Abstract:
Postural problems play a central role in the motor dysfunction of children with cerebral palsy (CP). Therefore, they spend more time in sitting than in standing to perform vital tasks of daily life. The focus of this article is to describe the pathophysiology of postural control in sitting and outline some implications for management and treatment. In general, children with CP exhibit muscular activity counteracting forces that disturb equilibrium. Only 'non-sitting' children with severe CP lack such 'direction-specific' adjustments, possibly ruling out achievement of independent sitting. Most frequently, the children display dysfunctions in the adaptation of the adjustment. Typical characteristics of this adaptation in children with CP are a top-down recruitment of postural muscles, an excessive degree of antagonistic coactivation, and an incomplete adaptation of the EMG-amplitude to task specific constraints. Despite our knowledge on the pathophysiology underlying the postural problems in children with CP, little 'high-level' evidence (according to Sackett) exists on how different interventions can affect these problems. Therapeutic attention to promote motor performance in sitting focuses on adaptive seating, tilting of the support surface, and ample, variable training in motivating settings. The challenge facing us now is to provide evidence about the efficacy of specific treatment approaches facilitating that children reach an optimal level of functioning in daily life.
