Opportunities for Early Intervention Based on Theory, Basic Neuroscience, and Clinical Science

摘要

The argument was that as the nervous system matures, higher levels of the central nervous system inhibit the freerunning action of the CPG, then restructure in subsequent months to drive the onset of walking.14,15 Thelen and Ulrich16,17 illustrated the dynamic and plastic nature of infant stepping by showing that intralimb and interlimb temporal and kinematic characteristics of newborn steps persisted in other postures, such as supine kicking, and that stepping displayed its own trajectory of interlimb coordination patterns when the context was shifted and infants were supported upright on a motorized treadmill. Decreases in muscle mass and strength and loss of bone density also are outcomes of casting that have been documented in adults, as well as reductions in the cortical motor area responsible for activating muscles surrounding the affected joint.100 The demands on caregivers' and therapists' time are high, and the physical strength required to assist children as they grow in practicing functional tasks grows with them; overall, the plan for optimizing the child's development must be balanced.