Anticipatory planning of movement sequences in hemiparetic cerebral palsy.

Anticipatory planning was examined in detail for a complex object manipulation task by capitalizing on both the complexity and the number of elements in the movement sequences in seven individuals with hemiparetic cerebral palsy (HCP) and seven left-handed control participants. Participants had to grasp a hexagonal knob using one of five possible grasping patterns as quickly as possible following a starting cue (condition I), and sometimes, they had to rotate it subsequently either 60 degrees or 120 degrees clockwise or counterclockwise (condition II). In the first condition, the HCP participants appear to anticipate the comfort of the different grasping patterns before movement onset, as controls did. However, when the task consisted of more than one movement part, HCP participants did not complete their planning processes before movement onset, which was contrary to controls. Instead, the results suggest that they use a step-by-step planning strategy, that is, they planned the latter parts of a movement sequence as the movement unfolds. The results are discussed in the light of possible capacity limitations of an internal model for grip selection, and a recent model on the planning and on-line control of movement performance.