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Anticipatory and compensatory postural adjustments in sitting in children with cerebral palsy
Aline Bigongiari1, Flávia de Andrade e Souza, Patrícia Martins Franciulli
1Laboratory of Biomechanics, University São Judas Tadeu, Brazil.
Insights
Children with cerebral palsy (CP) exhibit altered postural control strategies, relying more on compensatory adjustments and increased muscle co-activation during reaching tasks. This suggests developmental impacts of central nervous system disease on motor control.
Area of Science:
- Neuroscience
- Biomechanics
- Developmental Pediatrics
Background:
- Postural control is crucial for functional movements.
- Children with cerebral palsy (CP) often display motor impairments affecting postural stability.
- Understanding compensatory strategies in CP is vital for rehabilitation.
Purpose of the Study:
- To investigate postural control mechanisms during a reaching task in children with and without CP.
- To analyze the influence of ball mass and postural adjustments on muscle activity.
- To compare electromyography (EMG) patterns between typically developing children and those with CP.
Main Methods:
- Surface electromyography (EMG) was used to measure shoulder and trunk muscle activity.
- Participants performed a bilateral shoulder flexion to grasp balls of different masses (0.18 kg and 1 kg) from a sitting posture.
- Analysis included anticipatory (APA) and compensatory (CPA) postural adjustments, and muscle co-activation levels.
Main Results:
- Compensatory postural adjustments (CPA), heavier ball mass, and posterior trunk muscles showed greater EMG activity (p<.05).
- Children with CP exhibited significantly higher EMG and co-activation levels compared to controls (p<.05).
- A positive EMG-aging relationship was observed in controls, while a negative relationship was found in the CP group.
Conclusions:
- Children's primary postural control strategy involves reactive corrections post-movement initiation.
- Cerebral palsy impacts postural control development, leading to increased muscle co-activation.
- These findings highlight the need for targeted interventions to improve motor control in children with CP.
Abstract:
The aim of this study was to examine postural control in children with cerebral palsy performing a bilateral shoulder flexion to grasp a ball from a sitting posture. The participants were 12 typically developing children (control) without cerebral palsy and 12 children with cerebral palsy (CP). We analyzed the effect of ball mass (1 kg and 0.18 kg), postural adjustment (anticipatory, APA, and compensatory, CPA), and groups (control and CP) on the electrical activity of shoulder and trunk muscles with surface electromyography (EMG). Greater mean iEMG was seen in CPA, with heavy ball, and for posterior trunk muscles (p<.05). The children with CP presented the highest EMG and level of co-activation (p<.05). Linear regression indicated a positive relationship between EMG and aging for the control group, whereas that relationship was negative for participants with CP. We suggest that the main postural control strategy in children is based on corrections after the beginning of the movement. The linear relationship between EMG and aging suggests that postural control development is affected by central nervous disease which may lead to an increase in muscle co-activation.
