POSTURAL CONTROL IN SITTING CHILDREN WITH CEREBRAL-PALSY

Children with cerebral palsy (CP) display postural problems, largely i nterfering with daily life activities. Clarification of neural mechani sms controlling posture in these children could serve as a base for mo re successful intervention. Studies on postural adjustments following horizontal forward and backward displacements of a movable platform in ten school-age children with spastic diplegia and non-disabled contro ls revealed that sitting CP children, like standing CP children, show direction specific postural adjustments, indicating that the basic pat tern of muscle coordination in these conditions is conserved. Dysfunct ions are especially present in the modulation of the response pattern of ventral muscles during forward translations. They consist of: (1) a stereotyped and non-variable activation of all ventral muscles; (2) a n abnormal top-down muscle recruitment; and (3) an excessive degree of antagonistic co-activation. The altered patterns of muscle coordinati on could be the result of two interacting mechanisms, the primary defi cit due to the early brain damage and a compensation due to the postur al instability. Especially the latter dysfunction furnishes opportunit ies for therapeutic help. (C) 1998 Published by Elsevier Science Ltd. All rights reserved.