The long-term goal of this research is to understand the development of balance control in children with cerebral palsy (CP), and to determine how impairments in visual, somatosensory, and balance control limit the development of functionally independent mobility and reaching skills. The primary focus of previous balance research in this population has been to understand the neuromuscular constraints that limit static balance. We propose to extend this research to examine the sensory and attentional constraints on balance control during the dynamic conditions of gait and reaching. The first specific aim of the grant is: To determine the limitations on response capabilities faced by the child with cerebral palsy when confronted with threats to balance during walking. Four alternative hypotheses have been proposed to account for balance deficits during recovery from slips: 1) reduced postural response magnitudes, specifically in the ankle muscles; 2) slowed muscle response onsets, 3) increased co-activation of agonist-antagonist muscles, leading to a reduced efficiency of the response 4) an inappropriate activation sequence, with proximal muscles or antagonist muscles activated before distal agonists.
In specific aim 2, we will also study balance of children with CP under dual task conditions (balancing while performing a secondary task), another context with a high risk of falls. In this specific aim we will determine the attentional requirements of postural control in children with CP and whether the addition of a secondary attentional task causes deterioration in their postural control during locomotion. We hypothesize that children with visual spatial processing deficits will show reduced postural control when performing a secondary visual attention task, since the postural system also requires visual spatial processing. Finally, in specific aim 3 we will determine the extent to which a reduced ability to activate anticipatory postural adjustments before reaching contributes to reduced eye-hand coordination accuracy in children with cerebral palsy. Experiments will be performed to test the above hypotheses, using electromyographic, kinetic and kinematic analyses. In each specific aim we will examine the extent of the relationship between the motor dysfunction observed and the sensory capabilities of the children with CP.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
2R01NS038714-05A1
Application #
6731863
Study Section
Special Emphasis Panel (ZRG1-BDCN-5 (01))
Program Officer
Chen, Daofen
Project Start
1999-05-01
Project End
2007-12-31
Budget Start
2004-01-01
Budget End
2004-12-31
Support Year
5
Fiscal Year
2004
Total Cost
$263,723
Indirect Cost
Name
University of Oregon
Department
Other Basic Sciences
Type
Organized Research Units
DUNS #
948117312
City
Eugene
State
OR
Country
United States
Zip Code
97403
Saavedra, Sandra L; Woollacott, Marjorie H (2015) Segmental Contributions to Trunk Control in Children With Moderate-to-Severe Cerebral Palsy. Arch Phys Med Rehabil 96:1088-97
Boonyong, Sujitra; Siu, Ka-Chun; van Donkelaar, Paul et al. (2012) Development of postural control during gait in typically developing children: the effects of dual-task conditions. Gait Posture 35:428-34
Saavedra, Sandra L; van Donkelaar, Paul; Woollacott, Marjorie H (2012) Learning about gravity: segmental assessment of upright control as infants develop independent sitting. J Neurophysiol 108:2215-29
Saavedra, Sandra; Woollacott, Marjorie; van Donkelaar, Paul (2010) Head stability during quiet sitting in children with cerebral palsy: effect of vision and trunk support. Exp Brain Res 201:13-23
Butler, Penelope B; Saavedra, Sandy; Sofranac, Madeline et al. (2010) Refinement, reliability, and validity of the segmental assessment of trunk control. Pediatr Phys Ther 22:246-57
Saavedra, Sandra; Joshi, Aditi; Woollacott, Marjorie et al. (2009) Eye hand coordination in children with cerebral palsy. Exp Brain Res 192:155-65
Reilly, Dinah S; Woollacott, Marjorie H; van Donkelaar, Paul et al. (2008) The interaction between executive attention and postural control in dual-task conditions: children with cerebral palsy. Arch Phys Med Rehabil 89:834-42
Reilly, Dinah S; van Donkelaar, Paul; Saavedra, Sandy et al. (2008) Interaction between the development of postural control and the executive function of attention. J Mot Behav 40:90-102
Saavedra, Sandy; Woollacott, Marjorie; van Donkelaar, Paul (2007) Effects of postural support on eye hand interactions across development. Exp Brain Res 180:557-67
Burtner, P A; Woollacott, M H; Craft, G L et al. (2007) The capacity to adapt to changing balance threats: a comparison of children with cerebral palsy and typically developing children. Dev Neurorehabil 10:249-60

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