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Mirror visual feedback induces lower neuromuscular activity in children with spastic hemiparetic cerebral palsy
Max G Feltham1, Annick Ledebt, Frederik J A Deconinck
1Movement Science Group, School of Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford OX3 0BP, UK. mfeltham@brookes.ac.uk
Insights
Mirror feedback therapy can improve motor control in children with spastic hemiparetic cerebral palsy (SHCP). This therapy uses a mirror to create a visual illusion, enhancing bimanual coordination and reducing neuromuscular intensity.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Motor Control
Background:
- Spastic hemiparetic cerebral palsy (SHCP) affects motor function, particularly in bimanual coordination.
- Neuromuscular activation patterns are often altered in individuals with SHCP.
- Visual feedback plays a crucial role in motor learning and control.
Purpose of the Study:
- To investigate the effects of mirror feedback on neuromuscular activation during bimanual coordination in children with SHCP.
- To compare the impact of mirror feedback with other visual feedback conditions (glass/opaque screen).
- To explore the potential of mirror therapy to improve motor control in SHCP.
Main Methods:
- Eight children with SHCP and a matched control group participated.
- Bimanual symmetric circular arm movements were performed under different visual feedback conditions (mirror box, glass screen, opaque screen).
- Neuromuscular activation of shoulder and elbow muscles was measured.
Main Results:
- Mirror feedback significantly reduced neuromuscular intensities in the shoulder muscles of the less impaired arm in children with SHCP.
- Mirror feedback shortened the duration of eccentric and concentric activity in the elbow muscles of the more impaired arm.
- No significant effects of visual feedback were observed in the control group.
Conclusions:
- Replacing veridical visual feedback of the more impaired arm with a mirror reflection of the less impaired arm enhances motor control in SHCP.
- Mirror therapy may improve interlimb coupling and motor control by increasing ipsilateral motor cortex excitability and aligning sensory feedback with motor commands.
- These findings suggest mirror therapy as a promising intervention for improving upper limb function in children with SHCP.
Abstract:
The study examined the effects of mirror feedback information on neuromuscular activation during bimanual coordination in eight children with spastic hemiparetic cerebral palsy (SHCP) and a matched control group. The 'mirror box' creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. The study incorporated two additional visual feedback conditions by placing a glass or opaque screen between the arms. During bilateral symmetric circular arm movements mirror visual feedback induced lower neuromuscular intensities in the shoulder muscles of the less impaired arm of children with SHCP compared to the other visual conditions. In addition, the mirror lead to shorter relative durations of eccentric and concentric activity in the elbow muscles of the more impaired arm, whereas no effects of visual feedback were found in a matched control group. These results suggest that replacing veridical visual information of the more impaired arm with a mirror reflection of the less impaired arm improves the motor control of children with SHCP during interlimb coupling. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to: (1) increase ipsilateral motor cortex excitability and (2) congruence between afferent (visual) feedback and the internal copy of the motor commands.
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