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

• Published in: Research in developmental disabilities 2018-07, Vol.78, p.66-77
• Main Authors: Boxum, Anke G., Dijkstra, Linze-Jaap, la Bastide-van Gemert, Sacha, Hamer, Elisa G., Hielkema, Tjitske, Reinders-Messelink, Heleen A., Hadders-Algra, Mijna
• Format: Article
• Language: English
• Subjects: Cerebral palsy; Cystic periventricular leukomalacia; Electromyography; Infancy; Postural control
• ISSN: 0891-4222; 1873-3379
• DOI: 10.1016/j.ridd.2018.05.005

•VHR-infants with and without CP show a similar postural development during infancy.•VHR-infants with cPVL improve in direction-specificity during infancy.•VHR-infants without cPVL do not change in direction-specificity during infancy.•VHR-infants with cPVL do not change in postural fine-tuning during infancy.•VHR-infants without cPVL do improve in postural fine-tuning during infancy. Development 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. To 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. Longitudinal 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. VHR-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. VHR-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.