Anteroposterior balance reactions in children with spastic cerebral palsy

Aim To compare anterior and posterior standing balance reactions, as measured by single‐stepping thresholds, in children with and without spastic cerebral palsy (CP). Method Seventeen ambulatory children with spastic CP (eight males, nine females) and 28 typically developing children (13 males, 15 females; age range 5–12y, mean [SD] 9y 2mo [2y 3mo]), were included in this cross‐sectional, observational study. Balance reaction skill was quantified as anterior and posterior single‐stepping thresholds, or the treadmill‐induced perturbations that consistently elicited a step in that direction. In order to understand the underlying mechanisms of between‐group differences in stepping thresholds, dynamic stability was quantified using the minimum margin of stability. Ankle muscle activation latency, magnitude, and co‐contraction were assessed with surface electromyography. Results We observed an age and group interaction for anterior thresholds (p=0.001, partial η2=0.24). At older (≈11y; p