Department of Kinesiology and Nutrition, University of Illinois at Chicago, IL 60612, USA.
J Electromyogr Kinesiol. 2011 Dec;21(6):988-97. doi: 10.1016/j.jelekin.2011.08.013. Epub 2011 Oct 7.
Anticipatory postural adjustments (APAs) play an important role in the performance of many activities requiring the maintenance of standing posture. However, little is known about if and how children with cerebral palsy (CP) generate APAs. Two groups of children with CP (hemiplegia and diplegia) and a group of children with typical motor development performed arm flexion and extension movements while standing on a force platform. Electromyographic activity of six trunk and leg muscles and displacement of center of pressure (COP) were recorded. Children with CP were able to generate anticipatory postural adjustments and produce directionally specific APAs and COP displacements similar to those described in adults and typically developing children. However, children with diplegia were unable to generate APAs of the same magnitude as children with typical development and hemiplegia and had higher baseline muscle activity prior to movement. In children with diplegia, COP was posteriorly displaced and peak acceleration was smaller during bilateral extension compared to children with hemiplegia. The outcomes of the study highlight the role of APAs in the control of posture of children with CP and point out the similarities and differences in anticipatory control in children with diplegia and hemiplegia. These differences may foster ideas for treatment strategies to enhance APAs in children with CP.
姿势预备性调整（APAs）在许多需要维持站立姿势的活动中起着重要作用。然而，目前尚不清楚脑瘫（CP）患儿是否以及如何产生 APA。两组 CP 患儿（偏瘫和四肢瘫）和一组具有典型运动发育的儿童在力台上进行手臂屈伸运动。记录了 6 个躯干和腿部肌肉的肌电图活动和中心压力点（COP）的位移。CP 患儿能够产生姿势预备性调整，并产生与成人和正常发育儿童描述的方向特异性 APA 和 COP 位移相似的 APA 和 COP 位移。然而，与典型发育和偏瘫的儿童相比，四肢瘫的儿童无法产生相同幅度的 APA，并且在运动前基线肌肉活动更高。在四肢瘫的儿童中，与偏瘫的儿童相比，双侧伸展时 COP 向后移位，峰值加速度更小。该研究的结果强调了 APA 在 CP 患儿姿势控制中的作用，并指出了四肢瘫和偏瘫患儿在预备性控制方面的相似性和差异。这些差异可能为增强 CP 患儿的 APA 提供治疗策略的思路。
