{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:58:29Z","timestamp":1777870709902,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pcbi.1012209","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000}}],"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1192320N"],"award-info":[{"award-number":["1192320N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01 HD46922"],"award-info":[{"award-number":["R01 HD46922"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>Balance impairments are common in cerebral palsy. When balance is perturbed by backward support surface translations, children with cerebral palsy have increased co-activation of the plantar flexors and tibialis anterior muscle as compared to typically developing children. However, it is unclear whether increased muscle co-activation is a compensation strategy to improve balance control or is a consequence of reduced reciprocal inhibition. During translational perturbations, increased joint stiffness due to co-activation might aid balance control by resisting movement of the body with respect to the feet. In contrast, during rotational perturbations, increased joint stiffness will hinder balance control as it couples body to platform rotation. Therefore, we expect increased muscle co-activation in response to rotational perturbations if co-activation is caused by reduced reciprocal inhibition but not if it is merely a compensation strategy. We perturbed standing balance by combined backward translational and toe-up rotational perturbations in 20 children with cerebral palsy and 20 typically developing children. Perturbations induced forward followed by backward movement of the center of mass. We evaluated reactive muscle activity and the relation between center of mass movement and reactive muscle activity using a linear feedback model based on center of mass kinematics. In typically developing children, perturbations induced plantar flexor balance correcting muscle activity followed by tibialis anterior balance correcting muscle activity, which was driven by center of mass movement. In children with cerebral palsy, the switch from plantar flexor to tibialis anterior activity was less pronounced than in typically developing children due to increased muscle co-activation of the plantar flexors and tibialis anterior throughout the response. Our results thus suggest that a reduction in reciprocal inhibition causes muscle co-activation in reactive standing balance in children with cerebral palsy.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1012209","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T17:58:44Z","timestamp":1718301524000},"page":"e1012209","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combined translational and rotational perturbations of standing balance reveal contributions of reduced reciprocal inhibition to balance impairments in children with cerebral palsy"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-0401","authenticated-orcid":true,"given":"Jente","family":"Willaert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaat","family":"Desloovere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Van Campenhout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena H.","family":"Ting","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedl","family":"De Groote","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"pcbi.1012209.ref001","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/BF00238781","article-title":"Stance Posture Control in Select Groups of Children with Cerebral Palsy: Deficits in Sensory Organization and Muscular Coordination.","volume":"49","author":"LM Nashner","year":"1983","journal-title":"Exp Brain Res"},{"key":"pcbi.1012209.ref002","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1017\/S0012162205000885","article-title":"Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: a pilot study.","volume":"47","author":"M Woollacott","year":"2005","journal-title":"Dev Med Child Neurol"},{"key":"pcbi.1012209.ref003","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1080\/17518420701303066","article-title":"The capacity to adapt to changing balance threats: a comparison of children with cerebral palsy and typically developing children.","volume":"10","author":"PA Burtner","year":"2007","journal-title":"Dev Neurorehabilitation"},{"key":"pcbi.1012209.ref004","article-title":"Increased muscle responses to balance perturbations in children with cerebral palsy can be explained by increased sensitivity to center of mass movement.","author":"J Willaert","year":"2023","journal-title":"Gait Posture."},{"key":"pcbi.1012209.ref005","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1002\/ana.410120409","article-title":"Reciprocal excitation of antagonistic muscles as a differentiating feature in spasticity","volume":"12","author":"BM Myklebust","year":"1982","journal-title":"Ann Neurol"},{"key":"pcbi.1012209.ref006","doi-asserted-by":"crossref","first-page":"240","DOI":"10.2310\/7010.2006.00068","article-title":"Short- and Long-Latency Contributions to Reciprocal Inhibition During Various Levels of Muscle Contraction of Individuals With Cerebral Palsy","volume":"21","author":"CT Leonard","year":"2006","journal-title":"J Child Neurol"},{"key":"pcbi.1012209.ref007","first-page":"1","article-title":"Cerebral palsy.","volume":"2","author":"HK Graham","year":"2016","journal-title":"Nat Rev Dis Primer"},{"key":"pcbi.1012209.ref008","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1136\/jnnp.42.7.606","article-title":"Pathophysiological mechanisms in cerebral palsy","volume":"42","author":"HS Milner-Brown","year":"1979","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"pcbi.1012209.ref009","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1177\/0883073896011001S02","article-title":"Neuropathophysiology of Movement Disorders in Cerebral Palsy","volume":"11","author":"FM Filloux","year":"1996","journal-title":"J Child Neurol"},{"key":"pcbi.1012209.ref010","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1111\/j.1469-8749.1990.tb08120.x","article-title":"Deficits in reciprocal inhibition of children with cerebral palsy as revealed by H reflex testing.","volume":"32","author":"CT Leonard","year":"1990","journal-title":"Dev Med Child Neurol"},{"key":"pcbi.1012209.ref011","article-title":"Reciprocal inhibition in man.","author":"C. 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