Skip to main content
SpringerLink
Log in

Anticipatory postural adjustments associated with a loading perturbation in children with hemiplegic and diplegic cerebral palsy

  • Research Article
  • Published:
Experimental Brain Research Aims and scope Submit manuscript

Abstract

Anticipatory postural adjustments (APAs) in preparation for predictable externally induced loading perturbation were studied in children with typically development (TD), hemiplegic (HEMI), and diplegic (DIPL) cerebral palsy. Twenty-seven children (n = 9 in each group) were asked to stand and catch a load dropped from a pre-specified height. Electrical activity of the leg and trunk muscles and center of pressure (COP) displacements were recorded to quantify the APAs. All groups were able to generate APAs prior to the perturbation, but the magnitude was smaller and the onset was delayed in the dorsal (agonist) postural muscles in both HEMI and DIPL as compared to TD. HEMI and DIPL also generated APAs in the antagonist postural muscles. Anticipatory backward COP displacement was significantly different from the baseline value only in the TD and HEMI. HEMI and DIPL displayed a different postural control strategy; HEMI showed no difference in background postural activity from TD, but with diminished APAs in the agonist postural muscles compared to TD, while DIPL showed a higher background postural activity and diminished APAs in the agonist postural muscles compared to TD. These differences are important to consider when designing rehabilitation programs to improve posture and movement control in children with hemiplegic and diplegic cerebral palsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Adkin AL, Frank JS, Carpenter MG, Peysar GW (2002) Fear of falling modifies anticipatory postural control. Exp Brain Res 143:160–170

    Article  PubMed  Google Scholar 

  • Aruin AS (2002) The organization of anticipatory postural adjustments. J Autom Control 12:31–37

    Article  Google Scholar 

  • Aruin AS (2003) The effect of changes in the body configuration on anticipatory postural adjustments. Mot Control 7:264–277

    Article  Google Scholar 

  • Aruin AS, Latash ML (1995) Direction specificity of the postural muscles in feed-forward postural reaction during fast voluntary arm movements. Exp Brain Res 103:323–332

    Article  CAS  PubMed  Google Scholar 

  • Aruin AS, Latash ML (1996) Anticipatory postural adjustments during self-initiated perturbations of different magnitude triggered by a standard motor action. Electroencephalogr Clin Neurophysiol Electromyogr 101:497–503

    CAS  Google Scholar 

  • Aruin AS, Shiratori T, Latash ML (2001) The role of action in postural preparation for loading and unloading in standing subjects. Exp Brain Res 138:458–466

    Article  CAS  PubMed  Google Scholar 

  • Aruin AS, Kanekar N, Lee Y-J (2015) Anticipatory and compensatory postural adjustments in individuals with multiple sclerosis in response to external perturbations. Neurosci Lett 591:182–186

    Article  CAS  PubMed  Google Scholar 

  • Barela JA, Focks GMJ, Hilgeholt T, Barela AMF, Carvalho RP, Savelsbergh GJP (2011) Perception-action and adaptation in postural control of children and adolescents with cerebral palsy. Res Dev Dis 32:2075–2083

    Article  Google Scholar 

  • Basmajian JV (1980) Electromyography–dynamic gross anatomy: a review. Am J Anat 159(3):245–260

    Article  CAS  PubMed  Google Scholar 

  • Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B et al (2005) Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 47:571–576

    Article  PubMed  Google Scholar 

  • Belen’kiĭ VE, Gurfinkel’ VS, Pal’tsev EI (1967) Control elements of voluntary movements. Biofizika 12:135–141

    PubMed  Google Scholar 

  • Bennis N, Roby-Brami A, Dufossé M, Bussel B (1996) Anticipatory responses to a self-applied load in normal subjects and hemiparetic patients. J Physiol Paris 90:27–42

    Article  CAS  PubMed  Google Scholar 

  • Benvenuti F, Stanhope SJ, Thomas SL, Panzer VP, Hallett M (1997) Flexibility of anticipatory postural adjustments revealed by self-paced and reaction-time arm movements. Brain Res 761:59–70

    Article  CAS  PubMed  Google Scholar 

  • Bigongiari A, Sausa FA, Franciulli F, Neto PM, Araujo RC, Mochizuki L (2011) Anticipatory and compensatory postural adjustments I sitting in children with cerebral palsy. Hum Mov Sci 30:648–657

    Article  PubMed  Google Scholar 

  • Bouisset S (2008) Do M-CC. Posture, dynamic stability, and voluntary movement. Neurophysiol Clin 38:345–362

    Article  CAS  PubMed  Google Scholar 

  • Bouisset S, Zattara M (1987) Biomechanical study of the programming of anticipatory postural adjustments associated with voluntary movement. J Biomech 20:735–742

    Article  CAS  PubMed  Google Scholar 

  • Brown JE, Frank JS (1987) Influence of event anticipation on postural actions accompanying voluntary movement. Exp Brain Res 67:645–650

    Article  CAS  PubMed  Google Scholar 

  • Burden A (2010) How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research. J Electromyogr Kinesiol 20:1023–1035

    Article  PubMed  Google Scholar 

  • Chang J-J, Wu T-I, Wu W-L, Su F-C (2010) Kinematical measure for spastic reaching in children with cerebral palsy. Clin Biomech (Bristol, Avon) 20:381–388

    Article  Google Scholar 

  • Cherng RJ, Su F-C, Chen J-J, Kuan T-S (1999) Performance of static standing balance in children with spastic diplegic cerebral palsy under altered sensory environments. Am J Phys Med Rehab 78:336–343

    Article  CAS  Google Scholar 

  • Damiano DL, Martellotta TL, Sullivan DJ, Granata KP, Abel MF (2000) Muscle force production and functional performance in spastic cerebral palsy: relationship of cocontraction. Arch Phys Med Rehabil 81:895–900

    Article  CAS  PubMed  Google Scholar 

  • Damiano D, Abel M, Romness M, Oeffinger D, Tylkowski C, Gorton G, Bagley A, Nicholson D, Barnes D, Calmes J, Kryscio R, Rogers S (2006) Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: are separate classifications needed? Dev Med Child Neurol 48(10):797–803

    Article  PubMed  Google Scholar 

  • De Wolf S, Slijper H, Latash ML (1998) Anticipatory postural adjustments during self-paced and reaction-time movements. Exp Brain Res 121:7–19

    Article  PubMed  Google Scholar 

  • Dewar R, Love S, Johnston LM (2015) Exercise interventions improve postural control in children with cerebral palsy: a systematic review. Dev Med Child Neurol 57(6):504–520. doi:10.1111/dmcn.12660

    Article  PubMed  Google Scholar 

  • Dickstein R, Shefi S, Marcovitz E, Villa Y (2004) Anticipatory postural adjustment in selected trunk muscles in poststroke hemiparetic patients. Arch Phys Med Rehabil 85:261–267

    Article  PubMed  Google Scholar 

  • Donker S, Ledebt M, Roerdink M, Savelsberg GJP, Beek PJ (2008) Children with cerebral palsy exhibit greater and regular postural sway than typically developing children. Exp Brain Res 184:363–370

    Article  PubMed  Google Scholar 

  • Eliasson AC, Krumlinde Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall AM, Rosenbaum P (2006) The manual ability classification system (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 48:549–554

    Article  PubMed  Google Scholar 

  • Feng J, Pierce R, Do KP, Aiona M (2014) Motion of the center of mass in children with spastic hemiplegia: balance, energy transfer, and work performed by the affected leg versus the unaffected leg. Gait Posture 39:570–576

    Article  PubMed  Google Scholar 

  • Ferdjallah M, Harris G, Smith P, Wertsch JJ (2002) Analysis of postural control synergies during quiet standing in healthy children and children with cerebral palsy. Clinical Biomech (Bristol, Avon) 17:203–210

    Article  Google Scholar 

  • Gantchev GN, Dimitrova DM (1996) Anticipatory postural adjustments associated with arm movements during balancing on unstable support surface. Int J Psychophysiol 22:117–122

    Article  CAS  PubMed  Google Scholar 

  • Garland SJ, Stevenson TJ, Ivanova T (1997) Postural responses to unilateral arm perturbation in young, elderly, and hemiplegic subjects. Arch Phys Med Rehabil 78:1072–1077

    Article  CAS  PubMed  Google Scholar 

  • Geertsen SS, Kirk H, Lorentzen J, Jorsal M, Johansson CB, Nielsen JB (2015) Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness. Clin Neurophysiol http://www.ncbi.nlm.nih.gov/pubmed/25757398

  • Girolami GL, Shiratori T, Aruin AS (2010) Anticipatory postural adjustments in children with typical motor development. Exp Brain Res 205(2):153–165

    Article  PubMed  Google Scholar 

  • Girolami GL, Shiratori T, Aruin AS (2011) Anticipatory postural adjustments in children with hemiplegia and diplegia. J Electromyogr Kinesiol 21:988–997

    Article  PubMed  Google Scholar 

  • Horak FB, Esselman P, Anderson ME, Lynch MK (1984) The effects of movement velocity, mass displaced, and task certainty on associated postural adjustments made by normal and hemiplegic individuals. J Neurol Neurosurg Psychiatry 47:1020–1028

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hsu W-L, Krishnamoorthy V, Scholz JP (2006) An alternative test of electromyographic normalization in patients. Muscle Nerve 33:232–241

    Article  PubMed  Google Scholar 

  • Ju YH, You JY, Cherng RJ (2010) Effect of task constraint on reaching performance in children with spastic diplegic cerebral palsy. Res Dev Disabil 31:1076–1082

    Article  PubMed  Google Scholar 

  • Krishnan V, Kanekar N, Aruin AS (2012) Anticipatory postural adjustments in individuals with multiple sclerosis. Neurosci Lett 506:256–260

    Article  CAS  PubMed  Google Scholar 

  • Lacquaniti F, Maioli C (1987) Anticipatory and reflex coactivation of antagonist muscles in catching. Brain Res 406:373–378

    Article  CAS  PubMed  Google Scholar 

  • Latash ML, Aruin AS, Neyman I, Nicholas JJ (1995) Anticipatory postural adjustments during self inflicted and predictable perturbations in Parkinson’s disease. J Neurol Neurosurg Psychiatry 58:326–334

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lavender SA, Marras WS, Miller RA (1993) The development of response strategies in preparation for sudden loading to the torso. Spine 18:2097–2105

    Article  CAS  PubMed  Google Scholar 

  • Liu W-Y, Zaino CA, McCoy SW (2007) Anticipatory postural adjustments in children with cerebral palsy and children with typical development. Pediatr Phys Ther 19:188–195

    Article  CAS  PubMed  Google Scholar 

  • Massion J (1992) Movement, posture and equilibrium: interaction and coordination. Prog Neurobiol 38:35–56

    Article  CAS  PubMed  Google Scholar 

  • Moreau N, Falvo M, Damiano D (2012) Rapid force generation is impaired in cerebral palsy and is related to decreased muscle size and functional mobility. Gait Posture. 35:154–158

    Article  PubMed  Google Scholar 

  • Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH (2008) Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol 50:744–750

    Article  PubMed  Google Scholar 

  • Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D et al (2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 109:8–14

    PubMed  Google Scholar 

  • Santos MJ, Kanekar N, Aruin AS (2010) The role of anticipatory postural adjustments in compensatory control of posture: 1. Electromyographic analysis. J Electromyogr Kinesiol 20:388–397

    Article  PubMed  Google Scholar 

  • Saxena S, Rao BK, Kumaran S (2014) Analysis of postural stability in children with cerebral palsy and children with typical development. Pediatr Phys Ther 26:325–330

    Article  PubMed  Google Scholar 

  • Shiratori T, Latash M (2001) Anticipatory postural adjustments during load catching by standing subjects. Clin Neurophysiol 112:1250–1265

    Article  CAS  PubMed  Google Scholar 

  • Slijper H, Latash M (2000) The effects of instability and additional hand support on anticipatory postural adjustments in leg, trunk, and arm muscles during standing. Exp Brain Res 135:81–93

    Article  CAS  PubMed  Google Scholar 

  • Slijper H, Latash ML, Rao N, Aruin AS (2002) Task-specific modulation of anticipatory postural adjustments in individuals with hemiparesis. Clin Neurophysiol 113:642–655

    Article  PubMed  Google Scholar 

  • Tomita H, Fujiwara K, Fukuya Y (2010a) Body alignment and postural muscle activity at quiet standing and anteriorposterior stability limits in children with spastic cerebral palsy. Disabil Rehabil 32:1232–1241

    Article  PubMed  Google Scholar 

  • Tomita H, Fukaya Y, Honma S, Ueda T, Yamamoto Y, Shionoya K (2010b) Anticipatory postural muscle activity associated with bilateral arm flexion while standing in individuals with spastic diplegic cerebral palsy: a pilot study. Neurosci Lett 479:166–170

    Article  CAS  PubMed  Google Scholar 

  • Tomita H, Fukuya Y, Ueda T, Honma S, Yamashita E, Yamamoto Y, Mori E, Shionoya K (2011) Deficits in task-specific modulation of anticipatory postural adjustments in individuals with spastic diplegic cerebral palsy. J Neurophys 105:2157–2168

    Article  Google Scholar 

  • Tomita H, Fukaya Y, Totsuka K, Tsukahara Y (2013) Deficits in anticipatory inhibition of postural muscle activity associated with load release while standing in individuals with spastic diplegic cerebral palsy. J Neurophys 109:1996–2006

    Article  Google Scholar 

  • Toussaint HM, Michies YM, Faber MN, Commissaris DCM, van Dieën JH (1998) Scaling anticipatory postural adjustments dependent on confidence of load estimation in a bi-manual whole-body lifting task. Exp Brain Res 120:85–94

    Article  CAS  PubMed  Google Scholar 

  • Viallet F, Massion J, Massarino R, Khalil R (1987) Performance of a bimanual load-lifting task by parkinsonian patients. J Neurol Neurosurg Psychiatry 50:1274–1283

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zaino CA, McCoy SW (2008) Reliability and comparison of electromyographic and kinetic measurements during a standing reach task in children with and without cerebral palsy. Gait Posture. 27:128–137

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are thankful to the children and families who generously participated in this study. We thank D. Tan, PT, PCS and S. Joshi, PT, MS, PCS for assistance with data collection, and Ilyse Zultowski, DPT, PT for assistance with manuscript editing. This study was supported in part by a Grant from the Neuro-Developmental Treatment Association and by Pathways.org.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL, 60612, USA

    T. Shiratori, G. L. Girolami & A. S. Aruin

Authors
  1. T. Shiratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. L. Girolami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. S. Aruin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. L. Girolami.

Ethics declarations

Conflict of interest

None of the authors have potential conflicts of interest to disclose.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 85 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shiratori, T., Girolami, G. & Aruin, A. Anticipatory postural adjustments associated with a loading perturbation in children with hemiplegic and diplegic cerebral palsy. Exp Brain Res 234, 2967–2978 (2016). https://doi.org/10.1007/s00221-016-4699-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00221-016-4699-0

Keywords

Search

Navigation