Are electromyographic patterns during gait related to abnormality level of the gait in patients with spastic cerebral palsy?
Treść / Zawartość
Purpose: One of the aims of the treatment in ambulant cerebral palsy (CP) patients is improvement of gait. Level of gait pathology is assessed by instrumented gait analysis, including surface electromyography. The aim of this study was to investigate the relation of the abnormality level of the gait and the co-contraction of the agonist-antagonist muscles, and relation between symmetry left /right leg in gait and symmetry of muscular activity. Methods: Fifty one patients with Cerebral Palsy underwent clinical assessment and instrumented gait analysis, including surface electromyography. Signals were bilaterally collected from rectus femoris, medial and lateral hamstrings, tibialis anterior, lateral gastrocnemius and gluteus maximus. In older children additionally signals from soleus and lateral vastus were recorded. Sixteen gait variables were selected to calculate Gillette Gait Index, separately for left and right leg. From the envelopes the series of cross-correlation coefficients were calculated. Results: Weak correlations were found between averaged agonist-antagonist correlation coefficient and Gillette Gait Index. Differences between hemiparetic less-involved legs, hemiparetic spastic legs, and diplegic legs were found for co-contraction of rectus femoris and biceps femoris and for averaged agonist-antagonist co-contraction. The differences between hemiparetic and diplegic groups were found for some muscle correlation coefficients. Conclusions: The results obtained in this study show, that the activity pattern of the leg muscles is specific for a given patient, and the dependence of the kinematics pathology on the abnormal activation pattern is not a direct one.
Bibliogr. 11 poz., wykr.
- . Bax M., Goldstein M., Rosenbaum P., Leviton A., Paneth N., Dan B., Jacobsson B., Damiano D. Proposed definition and classification of cerebral palsy, Develop Med Child Neurol, 2005, vol. 47, 571-576.
- . Domagalska M., Szopa A., Syczewska M., Pietraszek S., Kidon Z., Onik G. The relationship between clinical measurements and gait analysis data in children with cerebral palsy. Gait & Posture 2013, vol. 38, 1038 – 1043.
- . Hagberg B., Hagberg G., Beckung E., Uvebrant P. Changing panorama of cerebral palsy in Sweden. VIII. Prevalence and origin in the birth year period 1991-1994. Acta Paeditr, 2001, vol. 90, 271-277.
- . Patikas D., Wolf S.I., Schuster W., Armbrust P., Dreher T., Doderlein L. Electromyographic patterns in children with cerebral palsy: Do they change after surgery? Gait & Posture 2007, vol. 26, 362-371.
- . Schutte L.M., Narayanan U., Stout J.L., Selber P., Gage J.R., Schwartz M.H. An index for quantifying deviations from normal gait. Gait & Posture, 2000, vol. 11, 25-31.
- . Stewart C., Shortland A.P. The biomechanics of pathological gait - from muscle to movement. Acta Bioeng Biomech, 2010, vol. 12, 3-12.
- . van der Houwen L.E.E., Scholtes V.A., Becher J.G., Harlaar J. Botulinum toxin A injections do not improve surface EMG patterns during gait in children with cerebral palsy—A randomized controlled study. Gait & Posture, 2011, vol. 33(2), 147-151.
- . Wakeling J., Delaney R., Dudkiewicz I. A method for quantifying dynamic muscle dysfunction in children and young adults with cerebral palsy. Gait & Posture, 2007, vol. 25, 580-589.
- . Wren T.A.L., Do K.P., Rethlefsen S.A., Healy B. Cross-correlation as a method for comparing dynamic electromyograhy signals during gait. J Biomech, 2006, vol. 39, 2714-2718.
- . www.seniam.org
- . Zwaan E., Becher J.G., Harlaar J. Synergy of EMG patterns in gait as an objective measure of muscle selectivity in children with spastic cerebral palsy. Gait & Posture 2012, vol. 35, 111-115.
Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę.