Experimental Brain Research

, Volume 234, Issue 10, pp 2967–2978 | Cite as

Anticipatory postural adjustments associated with a loading perturbation in children with hemiplegic and diplegic cerebral palsy

  • T. Shiratori
  • G. L. Girolami
  • A. S. Aruin
Research Article


Anticipatory postural adjustments (APAs) in preparation for predictable externally induced loading perturbation were studied in children with typically development (TD), hemiplegic (HEMI), and diplegic (DIPL) cerebral palsy. Twenty-seven children (n = 9 in each group) were asked to stand and catch a load dropped from a pre-specified height. Electrical activity of the leg and trunk muscles and center of pressure (COP) displacements were recorded to quantify the APAs. All groups were able to generate APAs prior to the perturbation, but the magnitude was smaller and the onset was delayed in the dorsal (agonist) postural muscles in both HEMI and DIPL as compared to TD. HEMI and DIPL also generated APAs in the antagonist postural muscles. Anticipatory backward COP displacement was significantly different from the baseline value only in the TD and HEMI. HEMI and DIPL displayed a different postural control strategy; HEMI showed no difference in background postural activity from TD, but with diminished APAs in the agonist postural muscles compared to TD, while DIPL showed a higher background postural activity and diminished APAs in the agonist postural muscles compared to TD. These differences are important to consider when designing rehabilitation programs to improve posture and movement control in children with hemiplegic and diplegic cerebral palsy.


Cerebral palsy Anticipatory postural adjustments Posture External perturbation 



We are thankful to the children and families who generously participated in this study. We thank D. Tan, PT, PCS and S. Joshi, PT, MS, PCS for assistance with data collection, and Ilyse Zultowski, DPT, PT for assistance with manuscript editing. This study was supported in part by a Grant from the Neuro-Developmental Treatment Association and by

Compliance with ethical standards

Conflict of interest

None of the authors have potential conflicts of interest to disclose.

Supplementary material

221_2016_4699_MOESM1_ESM.docx (85 kb)
Supplementary material 1 (DOCX 85 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Physical TherapyUniversity of Illinois at ChicagoChicagoUSA

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