Postural adjustments in infants at very high risk for cerebral palsy before and after developing the ability to sit independently

Anke G. Boxum, Lieke C. van Balen, Linze-Jaap Dijkstra, Elisa G. Hamer, Tjitske Hielkema, Heleen A. Reinders-Messelink, Mijna Hadders-Algra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Background: Children with cerebral palsy (CP) have impaired postural control. Posture is controlled in two levels: direction-specificity, and fine-tuning of direction-specific adjustments, including recruitment order. Literature suggests that direction-specificity might be a prerequisite for independent sitting.

Aim: To study development of postural adjustments in infants at very high risk for CP (VHR-infants) during developing the ability to sit independently.

Method: In a longitudinal study surface electromyograms of the neck-, trunk- and arm muscles of 11 VHR-infants and 11 typically developing (TD) infants were recorded during reaching in sitting before and after developing the ability to sit unsupported (median ages: VFIR 8.0 and 14.9 months; TD 5.7 and 10.4 months). Sessions were video-recorded.

Results: In VHR- and TD-infants the prevalence of direction-specific adjustments and recruitment order did not change when the infant learned to sit independently. In VHR-infants able to sit independently more successful reaching was associated with a higher frequency of bottom-up recruitment (Spearman's rho = 0.828, p = 0.006) and a lower frequency of simultaneous recruitment (Spearman's rho = -0.701, p = 0.035), but not with more direction-specificity. In TD-infants not able to sit independently, more successful reaching was associated with higher rates of direction-specific adjustments at the neck level (Spearman's rho = 0.778, p = 0.014), but not with recruitment order.

Conclusions: In VHR- and TD-infants postural adjustments during reaching in terms of direction-specificity and recruitment order are not related to development of independent sitting. Postural adjustments are associated with success of reaching, be it in a different way for VHR- and TD-infants. (C) 2014 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)435-441
Number of pages7
JournalEarly Human Development
Volume90
Issue number9
DOIs
Publication statusPublished - Sep-2014

Keywords

  • Cerebral palsy
  • Postural control
  • EMG
  • Reaching
  • High risk infants
  • Sitting
  • RANDOMIZED CONTROLLED-TRIAL
  • SPASTIC DIPLEGIA
  • EXTERNAL PERTURBATIONS
  • PHYSICAL-THERAPY
  • SITTING CHILDREN
  • 1ST-HALF YEAR
  • MOVEMENTS
  • PROGRAM
  • HUMANS
  • SYSTEM

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