Experimental Brain Research

, Volume 192, Issue 2, pp 155–165 | Cite as

Eye hand coordination in children with cerebral palsy

  • Sandra Saavedra
  • Aditi Joshi
  • Marjorie Woollacott
  • Paul van Donkelaar
Research Article


Reaching to grasp an object of interest requires complex sensorimotor coordination involving eye, head, hand and trunk. While numerous studies have demonstrated deficits in each of these systems individually, little is known about how children with cerebral palsy (CP) coordinate multiple motor systems for functional tasks. Here we used kinematics, remote eye tracking and a trunk support device to examine the functional coupling of the eye, head and hand and the extent to which it was constrained by trunk postural control in 10 children with CP (6–16 years). Eye movements in children with CP were similar to typically developing (TD) peers, while hand movements were significantly slower. Postural support influenced initiation of hand movements in the youngest children (TD & CP) and execution of hand movements in children with CP differentially depending on diagnosis. Across all diagnostic categories, the most robust distinction between TD children and children with CP was in their ability to isolate eye, head and hand movements. Results of this study suggest that deficits in motor coordination for accurate reaching in children with CP may reflect coupled eye, head, and hand movements. We have previously suggested that coupled activation of effectors may be the default output for the CNS during early development.


Eye hand coordination Development Cerebral palsy Posture 



Cerebral palsy


Typically developing


  1. Bernstein NA (1984) The co-ordination and regulation of movement. In: Whiting (ed) Human motor actions bernstein reassessed. Elsevier, AmsterdamGoogle Scholar
  2. Biguer B, Jeannerod M, Prablanc C (1982) The coordination of eye, head and arm movements during reaching at a single visual target. Exp Brain Res 46(2):301–304PubMedCrossRefGoogle Scholar
  3. Chang JJ, Wu TI, Wu WL, Su FC (2005) Kinematical measure for spastic reaching in children with cerebral palsy. Clin Biomech 20:381–388CrossRefGoogle Scholar
  4. Chen YP, Yang TF (2007) Effect of task goals on the reaching patterns of children with cerebral palsy. J Mot Behav 39:317–324PubMedCrossRefGoogle Scholar
  5. Cordo PJ, Nashner LM (1982) Properties of postural adjustments associated with rapid arm movements. J Neurophysiol 47:287–382PubMedGoogle Scholar
  6. Dan B, Bouillot E, Bengoetxea A, Noel P, Kahn A, Cheron G (2000) Head stability during whole body movements in spastic diplegia. Brain Dev 22:99–101PubMedCrossRefGoogle Scholar
  7. Favilla M (2006) Reaching movements in children: accuracy and reaction time development. Exp Brain Res 169:122–125PubMedCrossRefGoogle Scholar
  8. Fedrizzi E, Bova S, Farinotti M, Inverno M, Savoiardo S (1998) Eye-movement disorders and visual-perceptual impairment in diplegic children born preterm: a clinical evaluation. Dev Med Child Neurol 40:682–688PubMedGoogle Scholar
  9. Gillen G, Boiangiu C, Neuman M, Reinstein R, Schaap Y (2007) Trunk posture affects upper extremity function of adults. Percept Mot Skills 104:371–380PubMedCrossRefGoogle Scholar
  10. Good WV, Jan JE, Burden SK, Skoczenski A, Candy R (2001) Recent advances in cortical visual impairment. Dev Med Child Neurol 43:56–60PubMedCrossRefGoogle Scholar
  11. Hadders-Algra M, van der Heide JC, Fock JM, Stremmelaar E, van Eykern LA, Otten B (2007) Effect of seat surface inclination on postural control during reaching in preterm children with cerebral palsy. Phys Ther 87:861–871PubMedGoogle Scholar
  12. Hay L (1978) Accuracy of children on an open-loop pointing task. Percept Mot Skills 47:1079–1082PubMedGoogle Scholar
  13. Hay L (1979) Spatial-temporal analysis of movements in children: motor programs versus feedback in the development of reaching. J Mot Behav 11:189–200Google Scholar
  14. Hung YC, Charles J, Gordon AM (2004) Bimanual coordination during a goal-directed task in children with hemiplegic cerebral palsy. Dev Med Child Neuro 46:746–753Google Scholar
  15. Huys R, Daffertshofer A, Beek P (2004a) Multiple time scales and multiform dynamics in learning to juggle. Motor Control 7:188–212Google Scholar
  16. Huys R, Daffertshofer A, Beek P (2004b) Multiple time scales and subsystem embedding in learning to juggle. Hum Mov Sci 23:315–336PubMedCrossRefGoogle Scholar
  17. Jacobson LK, Dutton GN (2000) Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. Surv Ophalmol 45:1–13CrossRefGoogle Scholar
  18. Jeannerod M. (1990) The coordination of eye, head, and arm movements during reaching for a visual target. In: The Neural and Behavioural Organization of goal-directed movements. Oxford University Press, New York, pp 41–50Google Scholar
  19. Katayama M, Tamas LB (1987) Saccadic eye-movements of children with cerebral-palsy. Dev Med Child Neurol 29:36–39PubMedGoogle Scholar
  20. Kelso S, Putnam C, Goodman D (1983) On the space-time structure of human interlimb co-ordination. Q J Exp Psychol A 35(2):347–375Google Scholar
  21. Kozeis N, Anogeianaki A, Mitova DT, Angianakis G, Mitov T, Klisarova A (2007) Visual function and visual perception in cerebral palsied children. Ophthalmic Physiol Opt 27:44–53PubMedCrossRefGoogle Scholar
  22. Lee SK, LeGare M, Zhang HP (1995) Conjugate eye movements: comparison of cerebral palsied and normal adults. Percept Mot Skills 81:575–591PubMedGoogle Scholar
  23. Mackey AH, Walt SE, Stott NS (2006) Deficits in upper-limb task performance in children with hemiplegic cerebral palsy as defined by 3-dimensional kinematics. Arch Phys Med Rehabil 87:207–215PubMedCrossRefGoogle Scholar
  24. Mutsaarts M, Steenbergen B, Bekkering H (2005) Anticipatory planning of movement sequences in hemiparetic cerebral palsy. Motor Control 9:439–458PubMedGoogle Scholar
  25. Mutsaarts M, Steenbergen B, Bekkering H (2006) Anticipatory planning deficits and task context effects in hemiparetic cerebral palsy. Exp Brain Res 172:151–162PubMedCrossRefGoogle Scholar
  26. Nwaobi OM, Brubaker CE, Cusick B, Sussman MD (1983) Electromyographic investigation of extensor activity in cerebral-palsied children in different seating positions. Dev Med Child Neurol 25:175–183PubMedCrossRefGoogle Scholar
  27. Nwaobi OM (1986a) Effects of body orientation in space on tonic muscle activity of patients with cerebral palsy. Dev Med Child Neurol 28:41–44PubMedGoogle Scholar
  28. Nwaobi OM (1986b) Seating orientations and upper extremity function in children with cerebral palsy. Phys Ther 67:1209–1212Google Scholar
  29. Ricken AXC, Bennett SJ, Savelsbergh GJP (2005) Coordination of reaching in children with spastic hemiparetic cerebral palsy under different task demands. Motor Control 9:357–371PubMedGoogle Scholar
  30. Ronnqvist L, Rosblad B (2007) Kinematic analysis of unimanual reaching and grasping movements in children with hemiplegic cerebral palsy. Clin Biomech 22:165–175CrossRefGoogle Scholar
  31. Saavedra S, Woollacott M, van Donkelaar P (2007) Effects of postural support on eye hand interactions across development. Exp Brain Res 180:557–567PubMedCrossRefGoogle Scholar
  32. Salati R, Borgatti R, Giammari G, Jacobson L (2002) Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia. Dev Med Child Neurol 44:542–550PubMedCrossRefGoogle Scholar
  33. Steenbergen B, Hulstign W, de Vries A, Berger M (1996) Bimanual movement coordination in spastic hemiparesis. Exp Brain Res 110:91–98PubMedCrossRefGoogle Scholar
  34. Steenbergen B, van der Kamp J (2004) Control of prehension in hemiparetic cerebral palsy: similarities and differences between the ipsi- and contra-lesional sides of the body. Dev Med Child Neurol 46:325–332PubMedCrossRefGoogle Scholar
  35. Steenbergen B, Meulenbroek RGJ (2006) Deviations in upper-limb function of the less-affected side in congenital hemiparesis. Neuropsychologia 44:2296–2307PubMedCrossRefGoogle Scholar
  36. Stoffregen TA, Smart LJ, Bardy BG, Pagulayan RJ (1999) Postural stabilization of looking. J Exp Psychol Hum Percept Perform 25:1641–1658CrossRefGoogle Scholar
  37. Stoffregen TA, Bardy BG, Bonnet CT, Pagulayan RJ (2006) Postural stabilization of visually guided eye movements. Ecol Psych 18(3):191–222CrossRefGoogle Scholar
  38. Sugden D, Utley A (1998) Interlimb coupling in children with hemiplegic cerebral palsy during reaching and grasping at speed. Dev Med Child Neurol 40:396–404PubMedGoogle Scholar
  39. van der Heide JC, Otten B, Stremmelaar E, Hadders-Algra M (2005) Kinematic characteristics of reaching movements in preterm children with cerebral palsy. Pediatr Res 57:883–889PubMedCrossRefGoogle Scholar
  40. van der Heide JC, Otten B, Stremmelaar E, van Eykern LA, Hadders-Algra M (2004) Postural control during reaching in preterm children with cerebral palsy. Dev Med Child Neurol 46:253–266PubMedCrossRefGoogle Scholar
  41. van Roon D, Steenbergen B, Meulenbroek RGJ (2004) Trunk recruitment during spoon use in tetraparetic cerebral palsy. Exp Brain Res 155:186–195PubMedCrossRefGoogle Scholar
  42. van Roon D, Steenbergen B, Meulenbroek RGJ (2005a) Movement-accuracy control in tetraparetic cerebral palsy: effects of removing visual information of the moving limb. Motor Control 9:372–394PubMedGoogle Scholar
  43. van Roon D, Steenbergen B, Meulenbroek RGJ (2005b) Trunk use and co-contraction in cerebral palsy as a regulatory mechanism for accuracy control. Neuropsychologia 43(4):497–508PubMedCrossRefGoogle Scholar
  44. van Thiel E, Meulenbroek RGJ, Hulstijn W, Steenbergen B (2000) Kinematics of fast hemiparetic aiming movements toward stationary and moving targets. Exp Brain Res 132:230–242PubMedCrossRefGoogle Scholar
  45. van Thiel E, Steenbergen B (2001) Shoulder and hand displacements during hitting, reaching, and grasping movements in hemiplegic cerebral palsy. Motor Control 5:166–182PubMedGoogle Scholar
  46. Verrel J, Bekkering H, Steenbergen B (2008) Eye-hand coordination during manual object transport with the affected and less affected hand in adolescents with hemiparetic cerebral palsy. Exp Brain Res 187(1):107–116PubMedCrossRefGoogle Scholar
  47. von Hofsten C, Ronnqvist L (1988) Preparation for grasping an object: a developmental study. J Exp Psychol Hum Percept Perform 14:610–621CrossRefGoogle Scholar
  48. von Hofsten C (2007) Action in development. Dev Sci 10:54–60CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Sandra Saavedra
    • 1
  • Aditi Joshi
    • 2
  • Marjorie Woollacott
    • 1
  • Paul van Donkelaar
    • 1
  1. 1.Human PhysiologyUniversity of OregonEugeneUSA
  2. 2.University of California Los AngelesLos AngelesUSA

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