The present paper reviews the development of postural adjustments during infancy. In the control of posture, two functional levels can be distinguished. The basic level deals with the generation of direction-specific adjustments meaning that dorsal muscles are primarily activated when the body sways forward, whereas ventral muscles are primarily activated when the body sways backward. The second level is involved in adaptation of the direction-specific adjustments. Postural development starts with a repertoire of direction-specific adjustments suggesting that the basic level of control has an innate origin. At first, during the phase of primary variability, postural activity is largely variable and can be minimally adapted to environmental constraints. At 3 months, postural activity shows a transient period during which few postural muscles participate in postural activity. From 6 months onward, the phase of secondary variability starts, during which the second level of postural control becomes functionally active and infants develop the ability to adapt postural activity to the specifics of the situation. Initially, adaptation can be accomplished in a simple way only, but from 9–10 months onward, it can be performed by the subtle adaptation of the degree of muscle contraction. Around 13–14 months, anticipatory postural adjustments emerge. It is concluded that the development of postural adjustments is characterized by four periods of transition occurring at the ages of 3, 6, 9-10, and 13-14 months. The major transition occurs at 6 months, when infants move from the phase of non-adaptive, primary variability to the phase of adaptive, secondary variability.

Mijna Hadders-Algra

Development of Postural Control During the First 18 Months of Life

A.  Gramsbergen

M.  Hadders-Algra

Discussion on Neurobiological and Clinical Aspects of Postural Control in Motor Behavior

The role of the mammalian cerebellum ranges from motor coordination, sensory-motor integration, motor learning, and timing to nonmotor functions such as cognition. In terms of motor function, the development of the cerebellum is of particular interest because animal studies show that the development of the cerebellar cortical circuitry closely parallels motor coordination. Ultrastructural analysis of the morphological development of the cerebellar circuitry, coupled with the temporal and spatial identification of the neurochemical substrates expressed during development, will help to elucidate their roles in the establishment of the cerebellar circuitry and hence motor activity. Furthermore, the convenience of a number of naturally occurring mouse mutations has allowed a functional dissection of the various cellular elements that make up the cerebellar circuitry. This understanding will also help in the approach to possible therapies of pathologies arising during development because tile cerebellum is especially prone to such perturbation because of its late development.

J. D. Swinny

J. J. L. van der Want

Cerebellar Development and Plasticity: Perspectives for Motor Coordination Strategies, for Motor Skills, and for Therapy

Hemiplegia is a physical impairment that can occur in childhood following head trauma, cerebral vascular accident or transient ischemic attack (stroke), brain tumor, or congenital or perinatal injury. One of the most disabling symptoms of hemiplegia is unilaterally impaired hand and arm function. Sensory and motor impairments in children with hemiplegia compromise movement efficiency. Such children often tend not to use the affected extremity, which may further exacerbate the impairments, resulting in a developmentally learned non-use of the involved upper extremity, termed ‘developmental disuse’. Recent studies suggest that children with hemiplegia benefit from intensive practice. Forced use and Constraint-lnduced Movement Therapy (CI therapy) are recent therapeutic interventions involving the restraint of the non-involved upper extremity and intensive practice with the involved upper extremity. These approaches were designed for adults with hemiplegia, and increasing evidence suggests that they are efficacious in this population. Recently, forced use and constraint-induced therapy have been applied to children with hemiplegia. In this review, we provide a brief description of forced use and CI therapy and their historical basis, provide a summary of studies of these interventions in children, and discuss a number of important theoretical considerations, as well as implications for postural control. We will show that whereas the studies to date suggest that both forced use and CI therapy appear to be promising for improving hand function in children with hemiplegia, the data are limited. Substantially more work must be performed before this approach can be advocated for general clinical use.

Jeanne Charles

Andrew M. Gordon

A Critical Review of Constraint-Induced Movement Therapy and Forced Use in Children With Hemiplegia

Erect posture in man is a recent affordance from an evolutionary perspective. About eight million years ago, the stock from which modern humans derived split off from the ape family, and from around sixty-thousand years ago, modern man developed. Upright gait and manipulations while standing pose intricate cybernetic problems for postural control. The trunk, having an older evolutionary history than the extremities, is innervated by medially descending motor systems and extremity muscles by the more recent, laterally descending systems. Movements obviously require concerted actions from both systems. Research in rats has demonstrated the interdependencies between postural control and the development of fluent walking. Only 15 days after birth, adult-like fluent locomotion emerges and is critically dependent upon postural development. Vesttibular deprivation induces a retardation in postural development and, consequently, a retarded development of adult-like locomotion. The cerebellum obviously has an important role in mutual adjustments in postural control and extremity movements, or, in coupling the phyiogenetic older and newer structures. In the human, the cerebellum develops partly after birth and therefore is vulnerable to adverse perinatal influences. Such vulnerability seems to justify focusing our scientific research efforts onto the development of this structure.

Albert  Gramsbergen

Postural Control in Man: The Phylogenetic Perspective

In this review paper, we summarize the important contributions of the basal ganglia to the regulation of postural control. After a brief overview of basal ganglia circuitries, the emphasis is on clinical observations in patients with focal lesions in parts of the basal ganglia, as the impairments seen here can serve to highlight the normal functions of the basal ganglia nuclei in postural control. Two particularly relevant functions are discussed in detail: first, the contribution of the basal ganglia to flexibility and to gaining control of balancecorrecting responses, including the ability to lend priority to the elements of a postural task; and second, processing afferent information by the basal ganglia, which is increasingly recognized as being highly relevant for postural control.

Jasper E. Visser

Bastiaan R. Bloem

Role of the Basal Ganglia in Balance Control

Control of posture is a prerequisite for efficient motor performance. Posture depends on muscles capable of enduring contractions, whereas movements often require quick, forceful muscle actions. To serve these different goals, muscles contain fibers that meet these different tasks. Muscles with strong postural functions mainly consist of slow muscle fibers with a great resistance against fatigue. Flexor muscles in the leg and arm muscles are mainly composed of fast muscle fibers producing relatively large forces that are rapidly fatigable. Development of the neuromuscular system continues after birth. We discuss in the human baby and in animal experiments changes in muscle fiber properties, regression from polyneural into mononeural innervation, and developmental changes in the motoneurons of postural muscles during that period. The regression of poly-neural innervation in postural muscles and the development of dendrite bundles of their motoneurons seem to be linked to the transition from the immature into the adult-like patterns of moving and postural control.

J.  IJkema-Paassen

Development of Postural Muscles and Their Innervation

Postural problems play a central role in the motor dysfunction of children with cerebral palsy (CP). Therefore, they spend more time in sitting than in standing to perform vital tasks of daily life. The focus of this article is to describe the pathophysiology of postural control in sitting and outline some implications for management and treatment. In general, children with CP exhibit muscular activity counteracting forces that disturb equilibrium. Only ‘non-sitting’ children with severe CP lack such ‘direction-specific’ adjustments, possibly ruling out achievement of independent sitting. Most frequently, the children display dysfunctions in the adaptation of the adjustment. Typical characteristics of this adaptation in children with CP are a top-down recruitment of pos tural muscles, an excessive degree of antagonistic coactivation, and an incomplete adaptation of the EMG-amplitude to task specific constraints. Despite our knowledge on the pathophysiology underlying the postural problems in children with CP, little ’high-level’ evidence (according to Sackett) exists on how different interventions can affect these problems. Therapeutic attention to promote motor performance in sitting focuses on adaptive seating, tilting of the support surface, and ample, variable training in motivating settings. The challenge facing us now is to provide evidence about the efficacy of specific treatment approaches facilitating that children reach an optimal level of functioning in daily life.

Eva Brogren Carlberg

Postural Dysfunction in Children With Cerebral Palsy: Some Implications for Therapeutic Guidance

The present paper presents clinical and neurophysiological data of postural behavior in preterm children without CP. Clinical followup studies of preterm infants until toddler and school age have reported that low-risk preterm infants may have atypical postural behavior in terms of reduced amount of rotation during crawling, delayed dynamic balance, delayed onset of and a poor quality of early walking behavior. At school age, dysfunctions such as problems in standing on one leg and poor hopping are reported. Neurophysiological data of postural control at early age indicated the presence of a dysfunction in the capacity to modulate postural activity, and the postural activity has been characterized by temporal disorganization of EMG responses. Postural responses to goal-directed reaching in supine lying have been recorded and analyzed in terms of the total body center of pressure. In this study, preterm infants show less mobile postural behavior compared with full-term infants. In infancy, the less mobile postural behavior seemed to be adequate as it was related to better goal-directed reaching quality, but the results indicated that the relatively immobile postural  behavior during reaching in early age was related to less favorable neuromotor behavior in school-age.

Bjørg Fallang

Postural Behavior in Children Born Preterm

About this journal

Neural Plasticity is an interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology.

Journal profile

Meet the editorial board

Chief Editor, Professor Baudry, is currently University Professor at Western University of Health Sciences in Pomona, CA. His research focuses on understanding the molecular/cellular mechanisms of learning and memory and neurodegeneration.

Editor spotlight

Submit to Special Issue

We currently have a number of Special Issues open for submission. Special Issues highlight emerging areas of research within a field, or provide a venue for a deeper investigation into an existing research area.

Special Issues

Author guidelines

Editorial board

Databases and indexing

title

Neural Plasticity is an interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology.

description

https://images.hindawi.com/journals/np/np.banner.jpg

twitter:card

twitter:description

twitter:site

twitter:title

twitter:url

twitter:image

Neural Plasticity | Hindawi

Neural Plasticity

This Issue is now open for submissions.
Papers are published upon acceptance, regardless of the Special Issue publication date.