Lower limb muscle fatigue during walking in children with cerebral palsy
Maaike M Eken1,2, Siri M Braendvik3,4, Ellen Marie Bardal3
1Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Insights
Children with cerebral palsy (CP) experience greater lower leg muscle fatigue during walking than their peers. This increased muscle fatigue may impact their walking ability.
Area of Science:
- Neurology
- Pediatrics
- Biomedical Engineering
Background:
- Cerebral palsy (CP) affects motor function, potentially impacting gait and muscle usage.
- Understanding muscle fatigue in children with CP is crucial for developing targeted interventions.
Purpose of the Study:
- To compare muscle fatigue signs during self-paced walking in children with CP versus typically developing peers.
- To identify specific muscle groups affected by fatigue in children with CP.
Main Methods:
- A case-control study involving 13 children with CP and 14 typically developing children.
- Electromyography (EMG) was used to record muscle activity (median frequency and RMS) in lower and upper leg muscles during a 5-minute walk.
- Mixed linear model analyses were employed to assess the rate of change in EMG variables.
Main Results:
- Children with CP exhibited significantly greater decreases in median frequency and increases in RMS in lower leg muscles (gastrocnemius medialis, soleus) of the more affected leg.
- No significant muscle fatigue was observed in the upper leg muscles of children with CP.
Conclusions:
- Children with mild-to-moderate CP demonstrate increased selective muscle fatigue in their lower leg muscles during self-paced walking.
- This heightened muscle fatigue may contribute to limitations in walking capacity observed in children with CP.
Aim:
To investigate whether more prominent signs of muscle fatigue occur during self-paced walking in children with cerebral palsy (CP) compared to typically developing peers.
Method:
In this case-control study, 13 children with CP (four males, nine females; mean age [SD] 11y 4mo [3y 8mo]; nine in Gross Motor Function Classification System [GMFCS] level I, three in GMFCS level II, and one in GMFCS level III) and 14 typically developing peers (nine males, five females; mean age [SD] 9y 10mo [1y 10mo]) walked 5 minutes overground at a self-selected walking speed. Electromyography (EMG) median frequency and root mean square (RMS) were identified per gait cycle from EMG recordings of the tibialis anterior, gastrocnemius medialis, soleus, rectus femoris, and semitendinosus. Rate of change in those variables was analysed using mixed linear model analyses.
Results:
The decrease in EMG median frequency of gastrocnemius medialis and soleus and increase in EMG-RMS of tibialis anterior, gastrocnemius medialis, and soleus were significantly larger in the most affected leg of children with CP compared with typically developing peers.
Interpretation:
Increased selective muscle fatigue of the lower leg muscles was observed during self-paced walking in children with mild-to-moderate severe CP. This could contribute to and account for limited walking capacity.
What This Paper Adds:
Children with cerebral palsy (CP) show more signs of lower leg muscle fatigue than typically developing peers. No signs of muscle fatigue were observed in upper leg muscles of children with CP.
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