title: Effects of severity of gross motor disability on anticipatory postural adjustments while standing in individuals with bilateral spastic cerebral palsy.
abstract: BACKGROUND
  Although individuals with bilateral spastic cerebral palsy (BSCP) exhibit several deficits in anticipatory postural adjustments (APAs) while standing, effects of severity of motor disability on their APAs are unclear.
  
  
  OBJECTIVE
  To determine whether individuals with BSCP exhibit severity-dependent deficits in APAs.
  
  
  METHODS
  Seven individuals with level II BSCP (BSCP-II group) and seven with level III BSCP (BSCP-III group) according to the Gross Motor Function Classification System and seven healthy controls lifted a load under two different load conditions.
  
  
  RESULTS
  Anticipatory activities of the erector spinae (ES), medial hamstring (MH), and gastrocnemius (GCM) were smaller in the two BSCP groups than in the control group. Although the anticipatory GCM activity was similar between the BSCP groups, the ES and MH activities were larger in the BSCP-II group than in the BSCP-III group. In the BSCP-II group, an increase in anticipatory activity with an increase in load was observed in the MH, but not in the GCM. In the BSCP-III group, load-related modulation was not found in the MH or GCM.
  
  
  CONCLUSIONS
  The present findings suggest that in individuals with BSCP with severe motor disability, APA deficits extend to more proximal parts of the body.
authors.affiliation: Aichi Prefectural Hospital and Rehabilitation Center for Disabled Children, Dai-ni Aoitorigakuen, 5-1 Aza-yanagisawa, Motojyuku-cho, Okazaki 444-3505, Japan; Graduate School of Health Sciences, Toyohashi SOZO University, 20-1 Matsushita, Ushikawa-cho, Toyohashi 440-8511, Japan. Electronic address: h_tomita@sozo.ac.jp.
authors.forename: Hidehito
authors.initials: H
authors.lastname: Tomita
authors.affiliation: Aichi Prefectural Hospital and Rehabilitation Center for Disabled Children, Dai-ni Aoitorigakuen, 5-1 Aza-yanagisawa, Motojyuku-cho, Okazaki 444-3505, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Fukaya
authors.affiliation: Yachiyo Hospital, 2-2-7 Sumiyoshi-cho, Anjo 446-8510, Japan.
authors.forename: Yukina
authors.initials: Y
authors.lastname: Takagi
authors.affiliation: Suzukake Health Care Hospital, 2042-4 Ohara, Iwata 438-0043, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Yokozawa
mesh_terms: D000293:Adolescent; D064131:Back Muscles / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D004576:Electromyography; D005260:Female; D007839:Functional Laterality; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D004856:Postural Balance; D011187:Posture; D012720:Severity of Illness Index; D016474:Weight-Bearing; D055815:Young Adult
keywords: Anticipatory postural adjustments; Bilateral spastic cerebral palsy; Center of pressure; Electromyography; Gross motor function classification system