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Project properties

Title	Development of postural control in infants at high risk for cerebral palsy - effect of early intervention?
Keywords	postural control developmental disorder cerebral palsy infant EMG
Researchers	Prof. dr. M. Hadders-Algra
Type of project	Stage Wetenschap / Researchproject
Nature of the research	Analysis of EMG patterns, video-analysis, movement analysis
Fields of study	pediatrics neurology rehabilitation

Background / introduction

Postural control is fundamental to motor behaviour. Little is understood of the development of postural control in typically and atypically developing children. What we do know is that the control of posture in humans is very complex and involves virtually all parts of the nervous system. Therefore it is not too surprising that the development of postural control is a long-term process, which is not finished at preschool age, when children learn to run and jump, but lasts still adolescence. The complex nature of the postural control system makes it vulnerable for adverse conditions during early life, such as a pre- or perinatally acquired lesion of the brain or preterm birth. Indeed, children with disorders of the developing brain virtually always have minor or major dysfunctions in postural control.

The current project is part of a study on the effect of early intervention in infants at very high risk for cerebral palsy (LEARN2MOVE0-2 (L2M)). In L2M 40 infants are randomly allocated to one of two types of early intervention (COPCA, a new method, and traditional infant physiotherapy (TIP)). The intervention lasts for a year. Postural control during reaching is assessed at baseline and after 6 and 12 months intervention. Postural control during reaching is assessed in supine and sitting condition. To this end surface EMGs are recorded from neck, trunk, arm and legmuscles. The kinematics of movements is recorded and the whole session is recorede on video.

Research question / problem definition
- In what way does postural control of infants at very high risk for cerebral palsy differ from that of typically developing infants? - What is the effect of intervention on postural control?

Workplan
Tasks to be carried out: - EMG-analysis with the help of decidated software - Analysis of accompanying videos - Study of literature on development of postural control during typical and atypical development - Assist in current projects at Developmental Neurology in order to enhance understanding of developmental disorders.

References

1. Hadders-Algra M, Brogren Carlberg E (Eds): Postural control: a key issue in developmental disorders. Clin Dev Med No 179. London: Mac Keith Press, 2008.
2. Van der Heide JC, Begeer C, Fock A, Otten B, EF Stremmelaar, van Eykern LA, Hadders-Algra M. Postural control during reaching in preterm children with cerebral palsy. Dev Med Child Neurol 2004; 46: 253-66.
3. De Graaf-Peters VB, Bakker H, Van Eykern LA, Otten B, Hadders-Algra M. Postural adjustments and reaching in 4- and 6-months-old infants: an EMG and kinematical study. Exp Brain Res 2007; 181: 647-56.
4. De Graaf-Peters VB, Blauw-Hospers CH, Dirks T, Bakker H, Bos AF, Hadders-Algra M. Development of postural control in typically developing children and children with cerebral palsy: possibilities for intervention? Neurosci Biobehav Rev 2007; 31: 1191-1200.
5. Hielkema T, Hamer EG, Reinders-Messelink HA, Maathuis CGB, Bos AF, Dirks T, Van Doormaal L, Verheijden JMA, Vlaskamp C, Lindeman E, Hadders-Algra M. Learn 2 move 0-2 years: effects of a new intervention program in infants at very high risk for cerebral palsy – a randomized controlled trial. BMC Pediatrics, 2010, 10:76.
6.Hielkema T, Blauw-Hospers CH, Dirks T, Drijver-Messelink M, Bos AF, Hadders-Algra M. Does physiotherapeutical intervention affect motor outcome in high risk infants? A combined approach of RCT and process evaluation. Dev Med Child Neurol, 2011; 53: e8-e15.

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