Electromyographic patterns in children with cerebral palsy: do they change after surgery?

Area of Science:

• Orthopedics
• Neurology
• Biomedical Engineering

Background:

• Spastic cerebral palsy (CP) significantly impacts motor function, often requiring surgical intervention.
• Multilevel surgery aims to correct deformities and improve gait in children with CP.
• Understanding muscle activation changes post-surgery is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To investigate electromyographic (EMG) pattern alterations in lower limb muscles following multilevel surgical treatment in children with spastic cerebral palsy.
• To compare EMG changes between diplegic and hemiplegic CP subtypes.
• To assess the relationship between pre-operative abnormal muscle activation and post-operative outcomes.

Main Methods:

• Surface electromyograms (EMG) of seven lower limb muscles were recorded before and 1-5 years after surgery in 34 children with CP (diplegia and hemiplegia).
• Gait analysis was performed concurrently.
• A control group of 20 healthy children provided reference EMG patterns.

Main Results:

• EMG patterns of the soleus, lateral gastrocnemius, and tibialis anterior muscles showed improvement towards normal after surgery.
• No significant differences in EMG pattern changes were observed between diplegic and hemiplegic patients.
• A subgroup of patients exhibited a transient increase in medial hamstrings activation post-surgery.

Conclusions:

• Multilevel surgery can lead to beneficial changes in EMG patterns, though these are less pronounced than kinematic improvements.
• Abnormal pre-operative muscle activation, potentially compensatory, can be modulated by surgical intervention.
• Post-operative EMG monitoring is valuable for assessing treatment efficacy and understanding neuromuscular adaptations in pediatric CP.