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Quantifying muscle activity in non-ambulatory children with spastic cerebral palsy before and after selective dorsal
J E Perry1, B L Davis, M G Luciano
1Department of Biomedical Engineering (ND20), Lerner Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Insights
Selective dorsal rhizotomy surgery improved muscle activity in children with spastic cerebral palsy. Post-surgery, muscle function became more typical, reducing deficits in voluntary motor tasks.
Area of Science:
- Neurology
- Biomedical Engineering
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) presents with varied functional deficits.
- Objective measurement of muscle activity in non-ambulatory children with spastic CP during motor tasks is crucial.
- Selective dorsal rhizotomy (SDR) is a surgical intervention for spasticity in CP.
Purpose of the Study:
- To develop an objective method for quantifying muscle activity during a voluntary motor task.
- To assess the impact of SDR on muscle activity patterns in non-ambulatory children with spastic CP.
- To compare post-operative muscle activity in CP patients with age-matched controls.
Main Methods:
- Electromyography (EMG) and kinematic data were collected from the right leg during a hip/knee flexion task.
- Muscle activity (concentric, eccentric, isometric, inactive) was quantified for tibialis anterior, soleus, vastus lateralis, and biceps femoris.
- Data were analyzed pre- and post-SDR in eight children with CP and compared to eight controls.
Main Results:
- Post-SDR, isometric muscle activity decreased by 38%, and inactivity increased by 37%.
- Concentric and eccentric activity percentages showed no significant pre- vs. post-op differences.
- Post-operative muscle activity patterns in children with CP more closely matched control patterns, with a 50% reduction in differences.
Conclusions:
- The developed measurement technique shows promise for objectively quantifying muscle activity in non-ambulatory children with spastic CP.
- SDR surgery significantly altered muscle activity patterns, leading to more normalized muscle function during voluntary movement.
- Objective quantification of muscle activity can aid in evaluating treatment efficacy for cerebral palsy.
Abstract:
Cerebral palsy is a condition that results in varying degrees of functional deficits. The goal of this study was to develop an objective measure of muscle activity during a prescribed voluntary motor task in non-ambulatory children with spastic cerebral palsy. While performing a simultaneous hip/knee flexion task from the supine position, followed by return to the starting position, electromyographic and kinematic data were obtained from the right leg of eight children before and after selective dorsal rhizotomy and compared with eight age-matched controls. The electromyographic and kinematic data were combined to determine for each muscle of interest (tibialis anterior, soleus, vastus lateralis, biceps femoris) the percentage of the movement cycle for which the muscle was acting concentrically, eccentrically, isometrically or was considered inactive. Averaged over the four muscles, isometric activity decreased by 38% post-op and the time the muscles were inactive increased by 37% following surgery. The percentages of concentric and eccentric activity did not differ significantly between pre- and post-op conditions. Post-operatively, the percentage muscle activity patterns of the children with cerebral palsy more closely resembled that of the control children: averaged across all muscles and contraction types, the difference between the control children and the children with cerebral palsy was reduced by 50% following surgery. This measurement technique indicates promise as a method for quantifying muscle activity during voluntary motor tasks in non-ambulatory children with cerebral palsy.
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