Increased motor variability facilitates motor learning of improved trunk
postural control during sitting in children with cerebral palsy
Abstract
The goal of this study was to determine whether increasing motor
variability by applying varied perturbation forces to the pelvis during
sitting astride would facilitate motor learning of improved trunk
postural control in children with cerebral palsy (CP). Fourteen children
with spastic CP were tested in two conditions: CONSTANT and VARIED force
perturbations in two training sessions with each session lasted for 15
minutes. A custom robotic system was used to deliver repetitive
perturbation forces to the pelvis while participants sat astride.
Postural reactions to the unpredicted perturbations in the anterior and
posterior directions were tested before and after each training session.
Kinematics of head, trunk, and pelvis movement, and muscle
electromyography signals were recorded. One session of pelvis
perturbation training with either the CONSTANT (P = 0.028) or VARIED
force magnitudes (P = 0.009) induced an earlier onset of trunk extensor
under unpredicted perturbations. In addition, one session of pelvis
perturbation training with VARIED force magnitudes induced a significant
decrease in peak angle of head extension (P = 0.016), and an improvement
in recruitment order of the neck and trunk muscles under unpredicted
perturbations (P = 0.020). These results suggest that repeated pelvis
perturbations during sitting astride may induce improvement in muscle
activation onset under unpredicted perturbations in children with CP.
Moreover, repeated pelvis perturbations with varied force magnitudes,
which may increase motor variability, may lead to improvements in head
stability and muscle activation sequence of trunk and neck muscles in
response to unpredicted perturbations in children with CP.