Woollacott M H, Burtner P, Jensen J, Jasiewicz J, Roncesvalles N, Sveistrup H
Department of Exercise and Movement Science, University of Oregon, Eugene 97403, USA.
Neurosci Biobehav Rev. 1998 Jul;22(4):583-9. doi: 10.1016/s0149-7634(97)00048-1.
Studies on the development of balance control show a clear developmental progression of the emergence of organized muscle response patterns, with tonic background muscle activity decreasing and phasic bursts of activity emerging in all three agonist muscles in a synergic group (gastrocnemius-hamstrings-trunk extensors or tibialis anterior-quadriceps-abdominals) just prior to the onset of independent stance. The rudimentary ability to adapt postural responses to changing task conditions is present in children as young as 1 year of age. Older children with spastic diplegia have muscle activation patterns typically seen in normal children who are at the pull-to-stand stage of development, including poorly organized (proximal activated before distal muscles) responses with a high degree of antagonist co-activation. When normal children were asked to stand in a crouched posture like the CP children, the additional constraint caused muscle response patterns to resemble those of CP children, suggesting that differences in balance control in CP children are due to both CNS deficits and biomechanical changes in postural alignment.
关于平衡控制发展的研究表明，有组织的肌肉反应模式的出现呈现出明显的发展进程，在独立站立开始前，协同肌群（腓肠肌 - 腘绳肌 - 躯干伸肌或胫骨前肌 - 股四头肌 - 腹肌）中所有三块主动肌的紧张性背景肌肉活动减少，阶段性活动爆发出现。年仅1岁的儿童就具备根据不断变化的任务条件调整姿势反应的基本能力。患有痉挛性双侧瘫的大龄儿童具有通常在处于拉站发育阶段的正常儿童中所见的肌肉激活模式，包括组织不良（近端肌肉比远端肌肉先激活）的反应以及高度的拮抗肌共同激活。当要求正常儿童像脑性瘫痪儿童那样以蹲姿站立时，这种额外的限制导致肌肉反应模式类似于脑性瘫痪儿童，这表明脑性瘫痪儿童平衡控制的差异是由于中枢神经系统缺陷和姿势排列的生物力学变化共同导致的。
