Postural control and reaching throughout infancy: In cerebral palsy and in typical development

Cerebral palsy (CP) is caused by a lesion to the developing brain. It is characterized by motor impairments and postural problems. CP can only be reliably diagnosed from 18 months onwards, as a result of the high developmental activity in the young brain. The aim of this thesis was to study the development of postural problems in CP, to provide clues for early intervention. Because we studied infants younger than 18 months, we assessed muscle activity in infants at high risk of CP, and compared it to that of typically developing infants. The balance of the infants was disturbed by eliciting reaching movements when the researcher presented toys, while they were seated in an infant chair. Results suggested that in infancy, muscular postural control strategies improve with age rather than with functional performance, like developing the ability to sit or walk independently. All infants at high risk of CP ‘grow into a postural deficit’ with increasing age, which means that the problems become apparent at later age. However, infants with cystic periventricular leukomalacia, a severe brain lesion, already show postural difficulties at early age. Furthermore, all risk-infants with a later diagnosis of CP show from early age a worse reaching quality than infants who do not develop CP. The findings suggest that early intervention programs addressing postural dysfunction and motor skills such as reaching call for individual approaches for infants with different brain lesions and severity of symptoms.