Postural Dysfunction During Standing and Walking in Children With Cerebral Palsy: What are the Underlying Problems and What New Therapies Might Improve Balance?
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In this review we explore studies related to constraints on balance and walking in children with cerebral palsy (CP) and the efficacy of training reactive balance (recovering from a slip induced by a platform displacement) in children with both spastic hemiplegic and diplegic CP. Children with CP show (a) crouched posture, contributing to decreased ability to recover balance (longer time/increased sway); (b) delayed responses in ankle muscles; (c) inappropriate muscle response sequencing; (d) increased coactivation of agonists/antagonists. Constraints on gait include (a) crouched gait; (b) increased co‐activation of agonists/antagonists; (c) decreased muscle activation; (d) spasticity. The efficiency of balance recovery can be improved in children with CP, indicated by both a reduction in the total center of pressure path used during balance recovery and in the time to restabilize balance after training. Changes in muscle response characteristics contributing to improved recovery include reductions in time of contraction onset, improved muscle response organization, and reduced co‐contraction of agonists/antagonists. Clinical implications include the suggestion that improvement in the ability to recover balance is possible in school age children with CP.
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Postural control dysfunction in children with CP contributes to limitations in gross motor skills requiring balance, especially gait, upper limb activities, and oral motor activities.
“This dysfunction is known to contribute to limitations in gross motor skills that require balance, 16 especially gait, 17,18 during upper limb activities such as reaching, 19 and during oral motor activities such as eating, swallowing, and speaking. 20”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [17]
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References 12 · Cited by 264
- Authors
- Woollacott, M. H., & Shumway-Cook, A.
- Affiliations
- University of Oregon (US)
- Corresponding author
- Woollacott, Marjorie Hines
- Venue
- Neural Plasticity
- Publisher
- Wiley
- Published
- 2005-01
- Volume
- 12
- Issue
- 2-3
- Pages
- 211-219
- ISSN
- 1687-5443 (ISSN-L)
- 2090-5904
- PMC
- PMC2565447
- OpenAlex
- W2167742758
- Cited by
- 264
- References
- 12
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 14 · 2023: 13 · 2022: 18 · 2021: 18 · 2020: 20 · 2019: 10 · 2018: 20 · 2017: 18 · 2016: 18 · 2015: 16 · 2014: 17 · 2013: 22 · 2012: 7
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neural Plasticity (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (1R01 NS38714)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Keywords
- cerebral palsy, balance recovery, co-contraction, spasticity, spastic hemiplegia, spastic diplegia, children, postural control, center of pressure
- MeSH terms
- Cerebral Palsy, Child, Postural Balance, Gait, Humans, Muscle Contraction, Physical Fitness, Reaction Time, Muscle, Skeletal, Gait Disorders, Neurologic, Physical Therapy Specialty
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