Development of postural control in infancy in cerebral palsy and cystic periventricular leukomalacia.
cPVL, not CP alone, blocks the last tiny balance fixes you see in early infancy.
01Research in Context
What this study did
Boxum et al. (2018) watched how very high-risk babies learned to hold their bodies steady. They tracked infants who later got cerebral palsy and infants who had cystic periventricular leukomalacia (cPVL).
The team used video and force plates to score tiny sway changes every month. They wanted to see who could fine-tune balance and who could not.
What they found
Babies who got CP but no cPVL looked like other high-risk babies. Their sway direction got better month by month.
Babies with cPVL could pick the right sway direction, but the small, smooth adjustments stayed poor. The fine-tuning gap never closed.
How this fits with other research
Philip et al. (2020) pooled brain scans and found cPVL is the main marker for later vision problems in CP. G et al. now show cPVL also leaves a unique motor signature in the first year.
De Roubaix et al. (2025) used old home videos to spot later DCD. Like G et al., they show early movement quality predicts later diagnosis, but Amy looked at 18-month toddlers while G et al. caught the deficit in 4-month infants.
Hansen et al. (2025) saw high-risk CP babies lag in social play. Their motor data match G et al.’s timeline, hinting that poor postural control may limit face-to-face time from the start.
Why it matters
If you serve babies with brain injury, flag cPVL early. Directional sway may look okay, but the tiny fix-and-adjust moves stay weak. Add high-density postural games—slow weight shifts on a therapy ball, waterbed sitting, or parent-led tilt games—long before the infant sits alone. These drills target the fine-tuning loop that G et al. found stubbornly delayed.
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Join Free →Put the baby on a soft wedge, gently rock side-to-side, and pause—watch for ankle and trunk micro-corrections; reinforce each smoother sway with tickles or smiles.
02At a glance
03Original abstract
BACKGROUND: Development of postural problems in Cerebral Palsy (CP) is largely unknown. Postural muscle activity is organized into two levels: 1) direction-specificity; 2) fine-tuning of direction-specific activity. AIM: To study development of postural control until 21 months corrected age in subgroups of infants at very high-risk (VHR) of CP: a) with and without CP at 21 months; b) with and without cystic periventricular leukomalacia (cPVL), the brain lesion with highest risk of CP. METHODS AND PROCEDURES: Longitudinal electromyography recordings of postural muscles during reaching were made in 38 VHR-infants (severe brain lesion or clear neurological signs) between 4.7 and 22.6 months (18 CP, of which 8 with cPVL). Developmental trajectories were calculated using linear mixed effect models. OUTCOMES AND RESULTS: VHR-infants with and without CP showed virtually similar postural development throughout infancy. The subgroup of VHR-infants with cPVL improved performance in direction-specificity with increasing age, while they performed throughout infancy worse in fine-tuning of postural adjustments than infants without cPVL. CONCLUSIONS AND IMPLICATIONS: VHR-infants with and without CP have a similar postural development that differs from published trajectories of typically developing infants. Infants with cPVL present from early age onwards dysfunctions in fine-tuning of postural adjustments; they focus on direction-specificity.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.05.005