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Anticipatory postural adjustments in children with hemiplegia and diplegia

journal contribution
posted on 27.06.2012, 00:00 by Gay L. Girolami, Takako Shiratori, Alexander S. Aruin
Anticipatory postural adjustments (APAs) play an important role in the performance of many activities requiring the maintenance of standing posture. However, little is known about how or if children with cerebral palsy (CP) generate APAs. Two groups of children with CP (hemiplegia and diplegia) and a group of children with typical motor development performed arm flexion and extension movements while standing on a force platform. Electromyographic activity of six trunk and leg muscles and displacement of center of pressure (COP) were recorded. Children with CP were able to generate anticipatory postural adjustments, produce directionally specific APAs and COP displacements similar to those described in adults and typically developing children. However, children with diplegia were unable to generate APAs of the same magnitude as children with typical development and hemiplegia and had higher baseline muscle activity prior to movement. In children with diplegia, COP was posteriorly displaced and peak acceleration was smaller during bilateral extension compared to children with hemiplegia. The outcomes of the study highlight the role of APAs in control of posture of children with CP and point out the similarities and differences in anticipatory control in children with diplegia and hemiplegia. These differences may foster ideas for treatment strategies to enhance APAs in children with CP.


This study was supported in part by a grant from the Neuro-Developmental Treatment Association, Laguna Beach, CA.


Publisher Statement

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Electro - myography and Kinesiology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Electro - myography and Kinesiology, Vol 21, Issue 6, (December 2011) doi.org/10.1016/j.jelekin.2011.08.013







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