Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: a pilot study
Abstract
This study explored possible neural mechanisms that contribute to improvements in balance control produced by reactive balance training in children with cerebral palsy (CP). Six children with CP (four males, two females; mean age 9y 4mo), two with spastic hemiplegia (Gross Motor Function Classification System [GMFCS] level I) and four with spastic diplegia (GMFCS level II,) were given 5 days of intensive training in reactive balance control (100 perturbations per day on a moveable force platform). Surface electromyography was used to characterize changes in neuromuscular responses pretraining, immediately posttraining, and 1 month posttraining. Training in reactive balance control resulted in improvements in directional specificity of responses (a basic level of response organization) and other spatial/temporal characteristics including: (1) faster activation of muscle contraction after training, allowing children to recover stability faster; (2) emergence of a distal-proximal muscle sequence; and (3) improved ability to modulate the amplitude of muscle activity (increased amplitude of agonist and decreased amplitude of antagonist, reducing coactivation). Each child with spastic hemiplegia or diplegia showed a different combination of factors that contributed to improved performance; the level of change in neural factors depended on the severity of involvement of the child: hemiplegia vs diplegia, and level of involvement within each diagnostic category.
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Children with CP show deficits in anticipatory postural adjustments, reactive postural adjustments, and sensory and musculoskeletal components of postural control compared with children with typical development.
“To date, it is known that children with CP show deficits in anticipatory postural adjustments, 4 -9 and reactive postural adjustments, 10 -12 as well as sensory 4,13 and musculoskeletal components 14,15 of postural control, compared with children with typical development.”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [12]
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Exercise interventions improve postural control in children with cerebral palsy: a systematic review
Dewar, R., Love, S., & Johnston, L. M. (2015) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.12660 · Cited by 242 · see citing works
- Authors
- Woollacott, M., Shumway-Cook, A., Hutchinson, S., Ciol, M., Price, R., & Kartin, D.
- Affiliations
- University of Oregon (US)
- University of Washington (US)
- Corresponding author
- Woollacott, Marjorie
- Venue
- Developmental Medicine & Child Neurology
- Publisher
- Wiley
- Published
- 2007-02-13
- Volume
- 47
- Issue
- 7
- Pages
- 455-461
- ISSN
- 0012-1622 (ISSN-L)
- 1469-8749
- OpenAlex
- W4230346015
- Cited by
- 15
- References
- 21
- Citations by year
- 2024: 1 · 2020: 2 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Developmental Medicine & Child Neurology (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Keywords
- cerebral palsy, balance training, reactive balance control, muscle activity, surface electromyography, spastic hemiplegia, spastic diplegia, postural stability, co-contraction, children
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