Leijten, F. (Fran) (2014) Ontwikkeling van hoofdstabiliteit en reikbewegingen bij zuigelingen met een hoog risico op cerebrale parese. thesis, Medicine.
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Abstract
Introduction: Cerebral palsy (CP) is the most common neurological disorder in children. It is caused by early brain damage and leads to a variety of motor limitations. These deficits hamper control of posture in daily activities. An important goal of postural control is the stabilization of the head in space. In terms of muscle activity, postural control is organized in two functional levels: the basic level, which is direction specificity (e.g., activation of the dorsal muscles during a forward sway) and the second level, which is the fine tuning of the direction specific postural muscle activity for special situations (e.g., reaching). Older children with CP are known to have difficulty with stabilizing the head in space and the second level of postural control. Furthermore, reaching in older children with CP is of less quality than in healthy peers. This study aims to evaluate the development of head stability and reaching in infants at risk of CP. Methods: Eight infants at high risk of CP were assessed while reaching. During the first measurement (M1) when they were not able to sit independently, they were assessed in supported sitting position, whereas during the second measurement (M2) they were able to sit independently, and were assessed in this position. Video recordings of both sessions were used to record the kinematic characteristics of reaching and head displacement with the SIMI program. These parameters were subsequently analysed with the PedEMG Kinematics program. Mann-Whitney U, Wilcoxon and Spearman’s rho tests were used in the statistical analysis. Differences and correlations were considered statistically significant when p≤ 0,05. Results: In the entire study group older age and the ability to sit independently were associated with straighter reaching movements. The children who developed CP showed more head displacement during independent sitting (M2) than the children without CP. Interestingly, the children with CP showed more fluent reaching movements during supported sitting at M1. Faster reaching was correlated to a lesser head stability at M1. No correlation could be found between the rate of direction specificity with head displacement and reaching parameters. Conclusion: This study suggests that in infants at high risk of CP developing the ability to sit independently is associated with straighter reaching movements, but not with a change in head stability. The development of CP was associated with a better kinematic quality of reaching during supported sitting, and with a lesser head stability during independent sitting. The small sample size limits interpretation of the data, therefore future studies should include a larger number of participants. More knowledge of the development of head stability and patterns and deficits of reaching movements in infants with CP could lead to more effective early intervention programmes.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hadders-Algra, Prof. Dr. M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2495 |
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