Pathological and physiological muscle co-activation during active elbow extension in children with unilateral
Insights
Children with cerebral palsy (CP) exhibit abnormal muscle co-activation during elbow extension, varying with movement speed and phase. This co-activation is linked to spasticity and reduced range of motion.
Area of Science:
- Neurology
- Biomechanics
- Pediatrics
Background:
- Cerebral palsy (CP) often involves motor control deficits.
- Understanding muscle co-activation patterns is crucial for assessing upper limb function in children with CP.
Purpose of the Study:
- To investigate the roles and mechanisms of co-activation in flexor/extensor muscle pairs during elbow extension in children with CP.
- To differentiate co-activation patterns between typically developing (TD) children and those with unilateral spastic CP.
Main Methods:
- Surface electromyography (sEMG) and 3D motion analysis were used to record muscle activity and joint kinematics during elbow extension/flexion in 13 TD and 13 children with CP.
- Co-activation of brachioradialis/triceps and biceps/triceps muscle pairs was calculated during acceleration and deceleration phases of extension.
- Statistical analyses included linear mixed effects models and Spearman rank correlations.
Main Results:
- Children with CP showed strong, speed-dependent co-activation in both muscle pairs during the acceleration phase, unlike TD children.
- During deceleration, co-activation increased with speed in both groups, but was greater in children with CP for the brachioradialis/triceps pair.
- In children with CP, brachioradialis/triceps co-activation during deceleration was negatively correlated with extension range and positively correlated with flexor spasticity.
Conclusions:
- Abnormal co-activation patterns occur throughout elbow extension in children with CP, varying by movement phase and specific flexor muscles.
- Co-activation in children with CP presents both physiological and pathological characteristics, highlighting the complexity of motor control in this population.
Objective:
To address the roles and mechanisms of co-activation in two flexor/extensor pairs during elbow extension in children with cerebral palsy (CP).
Methods:
13 Typically Developing (TD) and 13 children with unilateral spastic CP performed elbow extension/flexion at different speeds. Elbow angle and velocity were recorded using a 3D motion analysis system. The acceleration and deceleration phases of extension were analyzed. Co-activation of the brachioradialis/triceps and biceps/triceps pairs was computed for each phase from surface electromyographic signals. Statistical analysis involved linear mixed effects models and Spearman rank correlations.
Results:
During the acceleration phase, there was strong co-activation in both muscle pairs in the children with CP, which increased with speed. Co-activation was weak in the TD children and it was not speed-dependent. During the deceleration phase, co-activation was strong and increased with speed in both groups; co-activation of brachioradialis/triceps was stronger in children with CP, and was negatively correlated with extension range and positively correlated with flexor spasticity.
Conclusions:
Abnormal patterns of co-activation in children with CP were found throughout the entire movement. Co-activation was specific to the movement phase and to each flexor muscle.
Significance:
Co-activation in children with CP is both physiological and pathological.
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