Anticipatory planning deficits and task context effects in hemiparetic cerebral palsy.

Individuals with hemiparetic cerebral palsy (HCP) display deviant motor output, predominantly on one side of the body. The question pursued here is whether HCP participants have the ability to anticipate the forthcoming perceptual-motor demands of the goal of an action sequence. Such anticipatory planning was necessary to successfully perform the tasks that were studied. In experiment I, HCP participants had to grasp a hexagonal knob with their unimpaired hand by choosing one of five possible grasping patterns (free choice) and consequently rotate it 60 degrees, 120 degrees, or 180 degrees clockwise or counterclockwise. HCP participants showed a large amount of task failures that were persistent throughout the task. These findings suggest a deficit in anticipatory planning. No such task failures were observed for the control group. In addition, the instructed degree of rotation had less effect on the selected grasping pattern for the HCP participants than for the controls. In experiment II, we investigated if HCP participants are prone to use context information that is directly available in the task, instead of planning the forthcoming perceptual-motor demands. To that aim, an arrow was inserted at one of the sides of the hexagon in a position that had no relevance for the action to be planned and executed. The location of this arrow significantly affected the grip selected in the HCP participants, but not in controls. Overall, the results suggest an anticipatory planning deficit in HCP participants that may be caused by an impairment at the motor imagery level. Consequently, as an alternative strategy, performance in HCP participants was predominantly based on information directly available in the task context.