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Dissertation
Anticipatory postural adjustments in children with cerebral palsy and children with typical development during forward reach tasks in standing
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
Dec 2001
DOI:
https://doi.org/10.17918/00008720
Abstract
The aim of this project was to explore the role of anticipatory postural adjustment (APA) in children with cerebral palsy (CP) and children with typical development (TD). A sample of convenience with 65 children, 37 with TD and 28 with CP, was included in this project. Using a repeated measures design, the following tasks in standing were examined: self-paced reaching at a comfortable speed and reaching as fast as possible to a stationary ball and reactive reaching to a moving ball. The APA activities were assessed by kinematic, electromyography, and center of pressure measurements. In addition, in order to explore relationships between clinical measures and laboratory measurements of APA activities, several clinical measures were also tested in this project. The major findings were as follows. First, regardless of age, children with TD produced spatial direction-specific APA patterns, such as posterior center of pressure excursion, and modulated the temporal and quantitative features of APA activities. A close relationship existed between the onset of APA activities and the initiation of reach movement. In addition, with increasing age, quicker and larger APA activities were noted in children with TD. Second, although children with CP used similar spatial direction-specific APA patterns as children with TD, APA activities in most children with CP were slower and smaller than children with TD. Furthermore, twelve out of 28 children with CP showed longer time delays between initiation of reach movement and onset of APA activities. Third, fair to excellent relationships between the three clinical measures and APA activities were noted. These three clinical measures were the functional reach test, the timed up and go test, and an upper extremity coordination test. Finally, among children with CP, APA activities were presented differently based upon several clinical factors, such as walking experience, vision problem, and severity of disability. The overall findings suggest that refinement of APA control in children with CP was different from children with TD. Further research needs to identify other influencing factors, which can interfere APA refinement in children with CP in order to develop effective intervention strategies.
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Details
- Title
- Anticipatory postural adjustments in children with cerebral palsy and children with typical development during forward reach tasks in standing
- Creators
- Wen-yu Liu
- Awarding Institution
- Medical College of Pennsylvania and Hahnemann University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Medical College of Pennsylvania and Hahnemann University; Philadelphia, Pennsylvania
- Number of pages
- xviii, 295 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002); College of Nursing and Health Professions (2000-2002)
- Other Identifier
- 991021888827204721