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

doi:10.1016/j.earlhumdev.2014.05.011

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

Early Hum Dev. 2014 Sep;90(9):435-41. doi: 10.1016/j.earlhumdev.2014.05.011. Epub 2014 Jun 25.

Authors

Anke G Boxum¹, Lieke C van Balen¹, Linze-Jaap Dijkstra¹, Elisa G Hamer¹, Tjitske Hielkema¹, Heleen A Reinders-Messelink², Mijna Hadders-Algra³

Affiliations

¹ University of Groningen, University Medical Center Groningen, Dept. Paediatrics - Developmental Neurology, Groningen, The Netherlands.
² Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.
³ University of Groningen, University Medical Center Groningen, Dept. Paediatrics - Developmental Neurology, Groningen, The Netherlands. Electronic address: m.hadders-algra@umcg.nl.

PMID: 24971932
DOI: 10.1016/j.earlhumdev.2014.05.011

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: VHR 8.0 and 14.9months; TD 5.7 and 10.4months). 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.

Clinical trial registration number: NTR1428.

Keywords: Cerebral palsy; EMG; High risk infants; Postural control; Reaching; Sitting.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cerebral Palsy / physiopathology*
Child Development*
Electromyography
Humans
Infant
Posture*
Risk Factors

Associated data

NTR/NTR1428