Shiratori T, Girolami G L, Aruin A S
Department of Physical Therapy, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL, 60612, USA.
Exp Brain Res. 2016 Oct;234(10):2967-78. doi: 10.1007/s00221-016-4699-0. Epub 2016 Jun 20.
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.
本研究对发育正常（TD）、偏瘫（HEMI）和双瘫（DIPL）型脑瘫儿童在准备应对可预测的外部诱发负荷扰动时的预期姿势调整（APA）进行了研究。27名儿童（每组n = 9名）被要求站立并接住从预先设定高度掉落的负荷。记录腿部和躯干肌肉的电活动以及压力中心（COP）位移，以量化APA。所有组在扰动前均能产生APA，但与TD组相比，HEMI组和DIPL组背侧（主动肌）姿势肌肉的APA幅度较小且起始延迟。HEMI组和DIPL组在拮抗肌姿势肌肉中也产生了APA。仅在TD组和HEMI组中，预期的向后COP位移与基线值有显著差异。HEMI组和DIPL组表现出不同的姿势控制策略；HEMI组与TD组相比，背景姿势活动无差异，但与TD组相比，主动肌姿势肌肉中的APA减少，而DIPL组与TD组相比，背景姿势活动较高，主动肌姿势肌肉中的APA减少。在设计康复计划以改善偏瘫和双瘫型脑瘫儿童的姿势和运动控制时，考虑这些差异很重要。
