{"id":704,"date":"2019-02-26T12:14:04","date_gmt":"2019-02-26T12:14:04","guid":{"rendered":"http:\/\/horizon.peachpuff-wolverine-566518.hostingersite.com\/?p=704"},"modified":"2019-02-26T12:14:04","modified_gmt":"2019-02-26T12:14:04","slug":"cerebral-palsy-studying-baby-steps-could-lead-to-better-treatments","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/horizon\/704\/cerebral-palsy-studying-baby-steps-could-lead-to-better-treatments\/","title":{"rendered":"Cerebral palsy: studying baby steps could lead to better treatments"},"content":{"rendered":"<div class=\"field field-name-field-header field-type-text-long field-label-hidden\">\n<div class=\"field-items\">\n<div class=\"field-item even\">\n<h3 class=\"selectionShareable\"><strong>Understanding the progression from the stepping reflex to independent walking could help find new therapies for children with cerebral palsy (CP) \u2013 a movement disability caused by brain damage before, during or shortly after birth.<\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"field field-name-body field-type-text-with-summary field-label-hidden\">\n<div class=\"field-items\">\n<div class=\"field-item even\">\n<p class=\"selectionShareable\">A baby\u2019s first steps are a magical moment \u2013 an early stepping stone towards independent walking. Children usually begin to walk around the time of their first birthday as they move from being an infant to become busy, curious and mobile toddlers.<\/p>\n<p class=\"selectionShareable\">Controlling leg muscles and achieving balance take time, but new-born babies already have an instinctive \u2018stepping reflex\u2019 hardwired into their neural circuitry. If you hold a baby with their feet touching the floor they will naturally make a stepping motion \u2013 a phenomenon also seen in other mammals.<\/p>\n<p class=\"selectionShareable\">\u2018We have tested three-day-old babies and found that they have a natural tendency to step forward,\u2019 said Dr Nadia Dominici, a researcher at the Vrije Universiteit Amsterdam in the Netherlands. \u2018The ability to walk on your own comes later.\u2019<\/p>\n<p class=\"selectionShareable\">Dr Dominici and her team are using the latest brain scanning and sensor technologies to study what happens as children develop the muscular and brain power required to walk on their own for a project called<a href=\"https:\/\/cordis.europa.eu\/project\/rcn\/206974\/factsheet\/en\" target=\"_blank\" rel=\"noopener noreferrer\">\u00a0Learn2Walk<\/a>.<\/p>\n<p class=\"selectionShareable\">In a\u00a0<a href=\"http:\/\/science.sciencemag.org\/content\/334\/6058\/997\" target=\"_blank\" rel=\"noopener noreferrer\">paper published in\u00a0<em>Science<\/em><\/a>\u00a0in 2011, Dr Dominici recorded muscular activity in the leg muscles of around 40 babies in their first days of life, and then repeated the experiment in toddlers around the time that they were taking their first steps. She found that new babies have two basic activation patterns that coordinate the leg muscles involved in the stepping reflex. These are later supplemented by two new ones that usually develop in the first year of life.<\/p>\n<p class=\"selectionShareable\"><strong>Patterns<\/strong><\/p>\n<p class=\"selectionShareable\">\u2018What I\u2019m looking at now is how and when these new (activation) patterns emerge, and the relationship between the muscles and the brain,\u2019 Dr Dominici said. \u2018We are looking at what happens in typically developing children and in those with CP.\u2019<\/p>\n<p class=\"selectionShareable\">Using a combination of movement sensors attached to the legs, and muscle activity and brain activity recordings, the team hopes to track how the brain develops in preparation for coordinating walking \u2013 and what happens in children who have mobility problems due to brain injuries such as CP.<\/p>\n<p class=\"selectionShareable\">\u2018In CP, the initial injury is in the brain, usually from birth. We want to understand exactly how this impairs their development of walking,\u2019 Dr Dominici said. \u2018This might help to improve treatment.\u2019<\/p>\n<p class=\"selectionShareable\">The project will investigate how therapies currently offered to children with CP affect the reorganisation of muscular or brain activity. Some treatments \u2013 such as supporting the limbs or immobilising certain muscles using Botox \u2013 may help reduce uncontrolled movements.<\/p>\n<p class=\"selectionShareable\">The question is whether these therapies trigger any changes at the neural level that might improve the ability to walk.<\/p>\n<p class=\"selectionShareable\">\u2018We then plan to trial a novel rehabilitation therapy in young children before they develop serious gait problems which are more difficult to correct,\u2019 she said. \u2018Depending on the type of CP and the level of severity, we hope it will be possible to train children to improve their mobility and independence.\u2019<\/p>\n<div class=\"quote-view quotesBlock quote_horizontal\">\n<blockquote>\n<p class=\"selectionShareable\">&#8216;We have tested three-day-old babies and found that they have a natural tendency to step forward.&#8217;<\/p>\n<p class=\"selectionShareable\">Dr Nadia Dominici, Vrije Universiteit Amsterdam, the Netherlands<\/p>\n<\/blockquote>\n<\/div>\n<p class=\"selectionShareable\"><strong>Balance<\/strong><\/p>\n<p class=\"selectionShareable\">Poor balance control is a common problem for people with CP, but the underlying causes of this imbalance are not well understood.<\/p>\n<p class=\"selectionShareable\">Dr Pieter\u00a0Meyns, an assistant professor in biomechanics at Hasselt University in Belgium, has investigated how computer games could be used to improve balance and explored how brain scans could be used to determine whether children will respond to training. He did this through a project that he led called\u00a0<a href=\"https:\/\/cordis.europa.eu\/project\/rcn\/195951\/factsheet\/en\" target=\"_blank\" rel=\"noopener noreferrer\">CP-RehOP<\/a>, conducted at the Amsterdam UMC.<\/p>\n<p class=\"selectionShareable\">\u2018The first problem is that there is no single area of the brain involved in balance control,\u2019 he explains. \u2018Because there are several types of CP, measuring the extent of a child\u2019s balance problem can also be difficult &#8211; the results vary depending on what (ability) you measure.\u2019 This could include, for instance, balance while standing still on two feet or reactions, says Dr Meyns.<\/p>\n<p class=\"selectionShareable\">Dr Meyns used the Microsoft XBox Kinect gaming system to deliver a six-week training programme to a group of children. The games console responds to the movement of the user\u2019s body, rather than by remote control. Twelve children with CP and nine without CP played football, tennis and bowling games five times per week for 30-minute sessions.<\/p>\n<p class=\"selectionShareable\">\u2018The games challenge the user\u2019s balance in different ways: in football, for example, they had to stand on one leg and swing the other leg while bowling and tennis require a different set of actions and balance reactions.\u2019<\/p>\n<p class=\"selectionShareable\">Participants had brain scans before and after the training to see how they responded.<\/p>\n<p class=\"selectionShareable\">\u2018We selected kids aged eight to 16 years who might be prone to balance problems,\u2019 Dr Meyns said. \u2018Depending on which balance measure we used, we found that some of the children improved on one measure of balance but not on others, illustrating how varied the CP population can be, and that balance deficits are most likely not caused by a single factor.\u2019<\/p>\n<p class=\"selectionShareable\">However, some participants improved their balance according to several of the measurements, leaving open the possibility that a subset of children with CP could benefit from the training course while others are less likely to improve.<\/p>\n<p class=\"selectionShareable\">\u2018The results were mixed,\u2019 says Dr Meyns. \u2018Even children with similar symptoms might not have the same type of balance disorder. What we need is big data from a much larger study to investigate the link between certain types of CP, balance problems and opportunities for training.\u2019<\/p>\n<p class=\"selectionShareable\">While people with CP are a diverse group, researchers hope new insights will change the timing and nature of interventions and lead to better outcomes in the years ahead. With CP being one of the most common childhood disabilities, Dr Meyns says with more time, money and bigger trials could significantly improve the lives of millions of children in the future.<\/p>\n<p class=\"selectionShareable\"><em>The research in this article was funded by the EU. If you liked this article, please consider sharing it on social media.<\/em><\/p>\n<p><em>Originally published on <a href=\"https:\/\/horizon-magazine.eu\">Horizon<\/a><\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Understanding the progression from the stepping reflex to independent walking could help find new therapies for children with cerebral palsy (CP) \u2013 a movement disability caused by brain damage before, during or shortly after birth. A baby\u2019s first steps are a magical moment \u2013 an early stepping stone towards independent walking. Children usually begin to &#8230; <a title=\"Cerebral palsy: studying baby steps could lead to better treatments\" class=\"read-more\" href=\"https:\/\/scienceblog.com\/horizon\/704\/cerebral-palsy-studying-baby-steps-could-lead-to-better-treatments\/\" aria-label=\"Read more about Cerebral palsy: studying baby steps could lead to better treatments\">Read more<\/a><\/p>\n","protected":false},"author":313,"featured_media":705,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"generate_page_header":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[12],"tags":[37,25,95,79,24],"class_list":["post-704","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-health","tag-innovation","tag-medicine","tag-research","tag-science"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Cerebral palsy: studying baby steps could lead to better treatments - Horizon Magazine Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scienceblog.com\/horizon\/704\/cerebral-palsy-studying-baby-steps-could-lead-to-better-treatments\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cerebral palsy: studying baby steps could lead to better treatments\" \/>\n<meta property=\"og:description\" content=\"Understanding the progression from the stepping reflex to independent walking could help find new therapies for children with cerebral palsy (CP) \u2013 a movement disability caused by brain damage before, during or shortly after birth. 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