Development of postural control in infancy in cerebral palsy and cystic periventricular leukomalacia

Publication date: July 2018
Source:Research in Developmental Disabilities, Volume 78
Author(s): Anke G. Boxum, Linze-Jaap Dijkstra, Sacha la Bastide-van Gemert, Elisa G. Hamer, Tjitske Hielkema, Heleen A. Reinders-Messelink, Mijna Hadders-Algra
BackgroundDevelopment of postural problems in Cerebral Palsy (CP) is largely unknown. Postural muscle activity is organized into two levels: 1) direction-specificity; 2) fine-tuning of direction-specific activity.AimTo study development of postural control until 21 months corrected age in subgroups of infants at very high-risk (VHR) of CP: a) with and without CP at 21 months; b) with and without cystic periventricular leukomalacia (cPVL), the brain lesion with highest risk of CP.Methods and proceduresLongitudinal electromyography recordings of postural muscles during reaching were made in 38 VHR-infants (severe brain lesion or clear neurological signs) between 4.7 and 22.6 months (18 CP, of which 8 with cPVL). Developmental trajectories were calculated using linear mixed effect models.Outcomes and resultsVHR-infants with and without CP showed virtually similar postural development throughout infancy. The subgroup of VHR-infants with cPVL improved performance in direction-specificity with increasing age, while they performed throughout infancy worse in fine-tuning of postural adjustments than infants without cPVL.Conclusions and implicationsVHR-infants with and without CP have a similar postural development that differs from published trajectories of typically developing infants. Infants with cPVL present from early age onwards dysfunctions in fine-tuning of postural adjustments; they focus on direction-specificity.



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