Related Experiment Video
Updated: Dec 27, 2025
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Anteroposterior balance reactions in children with spastic cerebral palsy
Jeremy R Crenshaw1, Drew A Petersen1,2, Benjamin C Conner1,3
1Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
Insights
Children with spastic cerebral palsy (CP) show age- and direction-specific balance impairments. Older typically developing children better manage instability by withholding steps, unlike their peers with CP.
Area of Science:
- Neurology
- Biomedical Engineering
- Pediatrics
Background:
- Cerebral palsy (CP) often impacts motor control, affecting balance reactions.
- Standing balance is crucial for mobility and falls prevention in children.
Purpose of the Study:
- To compare anterior and posterior standing balance reactions in children with and without spastic CP.
- To investigate age- and direction-specific differences in balance responses.
Main Methods:
- Cross-sectional study of 17 children with spastic CP and 28 typically developing children (ages 5-12).
- Quantified balance using anterior/posterior single-stepping thresholds via treadmill perturbations.
- Assessed dynamic stability (margin of stability) and ankle muscle activation (EMG).
Main Results:
- An age-by-group interaction was found for anterior thresholds.
- Older typically developing children had higher anterior stepping thresholds than those with CP.
- Older typically developing children recovered from greater instability before stepping.
Conclusions:
- Spastic CP causes age- and direction-specific impairments in standing balance reactions.
- Older typically developing children demonstrate a greater ability or willingness to maintain stability by withholding a step.
Aim:
To compare anterior and posterior standing balance reactions, as measured by single-stepping thresholds, in children with and without spastic cerebral palsy (CP).
Method:
Seventeen ambulatory children with spastic CP (eight males, nine females) and 28 typically developing children (13 males, 15 females; age range 5-12y, mean [SD] 9y 2mo [2y 3mo]), were included in this cross-sectional, observational study. Balance reaction skill was quantified as anterior and posterior single-stepping thresholds, or the treadmill-induced perturbations that consistently elicited a step in that direction. In order to understand the underlying mechanisms of between-group differences in stepping thresholds, dynamic stability was quantified using the minimum margin of stability. Ankle muscle activation latency, magnitude, and co-contraction were assessed with surface electromyography.
Results:
We observed an age and group interaction for anterior thresholds (p=0.001, partial η2 =0.24). At older (≈11y; p<0.001, partial η2 =0.48), but not younger (≈7y; p=0.33, partial η2 =0.02) ages, typically developing children had larger anterior thresholds than those with CP. In response to near-threshold anterior perturbations, older typically developing children recovered from more instability than their peers with CP (p=0.004, partial η2 =0.18). Older children had no between-group differences in ankle muscle activity. No between-group differences were observed in posterior thresholds.
Interpretation:
The effects of CP on balance reactions are age- and direction-specific. Older typically developing children are more able or willing to withhold a step when unstable.
What This Paper Adds:
Children with spastic cerebral palsy have age- and direction-specific balance-reaction impairments. Lower anterior stepping thresholds were observed in older, but not younger children. Older typically developing children withheld a forward step at higher levels of instability. No between-group differences were seen in posterior stepping thresholds.
More Related Videos
Related Concept Videos
01:21Rigid Body Equilibrium Problems - II
Consider two children sitting on a seesaw, which has negligible mass. The first child has a mass (m1) of 26 kg and sits at point A, which is 1.6 meters (r1) from the pivot point B; the second child has a mass (m2) of 32 kg and sits at point C. How far from the pivot point B should the second child sit (r2) to balance the seesaw?
01:22Indirect Motor Pathways
The vestibulospinal tract originates in the vestibular nuclei of the brainstem. The vestibular system detects changes in...