Vasani Priyal, Narayan Amitesh, Nayak Akshatha, Alsulaimani Mohammed, Alzahrani Abdul Rahman
Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Physiother Res Int. 2025 Jan;30(1):e70028. doi: 10.1002/pri.70028.
Anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA) have played a vital role in postural control since early childhood, which is critical to accomplishing activities in daily life. However, literature indicated dissimilarities and inconsistencies in APA and CPA analysis in sitting and standing positions in children with Cerebral Palsy (CP). Thus, this study analyzed the changes in postural control (APA and CPA) through the postural muscles [rectus abdominis (RA) and erector spinae (ES)] in both standing and sitting positions during functional activities (grasping a ball) in children with CP.
Children with CP [N = 21] aged 5-13 years having GMFCS levels I (n = 12) and II (n = 9) participated. Surface electromyography (EMG) was performed for postural muscles (ES and RA) to measure the APA and CPA with two types of loads (heavy and light) in both sitting and standing positions.
Children with CP showed increased EMG amplitude for APA and CPA with a heavier load than light load in sitting and standing positions. The EMG amplitude of CPA in sitting and standing for both load conditions was significantly higher than that of APA.
The findings suggest rehabilitation programs should enhance APA and CPA through targeted exercises and load management strategies. These insights have the potential to inform clinical practices, improve postural stability, and ultimately strengthen the ability of children with CP to perform daily activities with greater ease and confidence, thereby significantly impacting the quality of life.
自儿童早期起，预期姿势调整（APA）和代偿性姿势调整（CPA）在姿势控制中发挥着至关重要的作用，这对于完成日常生活活动至关重要。然而，文献表明，脑瘫（CP）儿童在坐姿和站姿下的APA和CPA分析存在差异和不一致。因此，本研究通过姿势肌肉[腹直肌（RA）和竖脊肌（ES）]分析了CP儿童在功能性活动（抓球）过程中站立和坐姿下姿势控制（APA和CPA）的变化。
纳入21名年龄在5至13岁之间、GMFCS水平为I级（n = 12）和II级（n = 9）的CP儿童。对姿势肌肉（ES和RA）进行表面肌电图（EMG）检查，以测量坐姿和站姿下两种负荷（重负荷和轻负荷）时的APA和CPA。
CP儿童在坐姿和站姿下，重负荷时APA和CPA的EMG幅度均高于轻负荷。在两种负荷条件下，坐姿和站姿时CPA的EMG幅度均显著高于APA。
研究结果表明，康复计划应通过有针对性的锻炼和负荷管理策略来增强APA和CPA。这些见解有可能为临床实践提供参考，改善姿势稳定性，并最终增强CP儿童更轻松、自信地进行日常活动的能力，从而显著影响生活质量。
