The development of postural control in infants at high risk for cerebral palsy.

Boxum, I. (Ilona) (2013) The development of postural control in infants at high risk for cerebral palsy. thesis, Medicine.

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Abstract

Introduction: Cerebral palsy (CP) is a heterogeneous group of disorders characterized by impaired motor function and postural deficits caused by non-progressive damage of the developing brain. Postural control is organized in two levels. The first level consists of direction-specificity, e.g. primarily recruiting dorsal muscles during forward bodysway. The second level deals with fine-tuning of direction-specific adjustments. At school-age, most children with CP have problems adapting the direction-specific adjustment to specific tasks. This study explores the development of postural control in infants at high risk (HR) for CP. Methods: In this longitudinal study, surface electromyograms (EMGs) of 10 HR-infants were recorded in supine and sitting position during reaching in early infancy (4-8 months corrected age) and late infancy (10-14 months corrected age). Sessions were recorded on video. EMG-signals of neck-, trunk-, leg- and arm muscles were analyzed with the PedEMG program. Similar video and EMG-data of 11 typically developing (TD) infants were available at 4, 6 and 10 months. Mann-Whitney and Wilcoxon tests were used in data-analyses; p<0.05 was considered statistically significant. Results: Generally, the prevalence of direction-specific adjustments did not differ between HR and TD-infants; it varied between 17-81% at various ages, body-levels, both positions and groups. However, two exceptions were present in supine: young HR infants showed more direction-specific postural adjustments at trunk level than 6-month-old TD-infants (median values 63% vs. 51% Mann-Whitney: p=0.034), and at neck level compared to 4-month-old TD-infants (median values 50% vs. 42%; Mann-Whitney: p=0.037). Findings at the second level of postural control were similar in HR and TD-infants. Limited data in sitting was available in HR-infants due to their postural problems in this position. Conclusion: This explorative study suggests that the development of the first and second level of postural control in HR-infants is characterized by variation and does not differ from TD-infants. Presumably this is true for the posturally non-challenging situation of supine position. The data in sitting were however too limited to draw similar conclusions for this situation. Further research with larger numbers HR-infants in sitting is required to improve understanding of postural impairments as this may lead to the development of optimal intervention programs.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Hadders-Algra, Prof. Dr. M. Developmen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:57
Last Modified:	25 Jun 2020 10:57
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1746

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