Woollacott M H, Burtner P
Department of Exercise and Movement Science, University of Oregon, Eugene 97403-1240, USA.
Acta Paediatr Suppl. 1996 Oct;416:58-62. doi: 10.1111/j.1651-2227.1996.tb14279.x.
Studies on the development of automatic postural responses in both typically developing children and children with cerebral palsy were performed. With the appearance of "pull-to-stand" behavior, typically developing children first began to show muscle responses to platform movements in mainly the ankle muscles. With increased development, additional agonist muscles were added to the response pattern and a consistent distal to proximal sequence began to emerge. Well-organized responses were seen with the onset of independent stance and walking, along with the reduction of antagonist muscle co-activation. The older children with cerebral palsy who were pre-walkers had immature muscle activation patterns like those seen in the typically developing children at the pull-to-stand stage of development. These included disorganized muscle responses and increased frequency of coactivation of both proximal-distal and agonist-antagonist muscles. In order to determine if musculoskeletal constraints contributed to these response patterns, normal children were asked to stand in a crouched posture similar to that of children with CP. This caused postural muscle response patterns to more closely approximate those of children with spastic diplegia.
对正常发育儿童和脑瘫儿童自动姿势反应的发展进行了研究。随着“拉站”行为的出现，正常发育儿童首先开始主要在踝部肌肉表现出对平台运动的肌肉反应。随着发育的进展，更多的主动肌被纳入反应模式，并且开始出现从远端到近端的一致顺序。随着独立站立和行走的开始，出现了组织良好的反应，同时拮抗肌的共同激活减少。处于学步前阶段的大龄脑瘫儿童具有不成熟的肌肉激活模式，类似于正常发育儿童在拉站发育阶段所观察到的模式。这些包括紊乱的肌肉反应以及近端-远端和主动肌-拮抗肌共同激活频率的增加。为了确定肌肉骨骼限制是否导致了这些反应模式，要求正常儿童以类似于脑瘫儿童的蹲姿站立。这使得姿势肌肉反应模式更接近痉挛性双侧瘫儿童的模式。
