Patterns of upper limb muscle activation in children with unilateral spastic cerebral palsy: Variability and
Aurélie Sarcher1, Sylvain Brochard2, François Hug3
1Motion Analysis Laboratory, Physical Medicine and Rehabilitation, University Hospital of Nantes, Nantes, France; Laboratory of Medical Information Processing (LaTIM), INSERM UMR 1101, Brest, France.
Insights
Analyzing upper limb electromyography (EMG) patterns in children with cerebral palsy (CP) reveals muscle activation differences. This method aids in detecting deviations and treatment effects in CP patients.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatrics
Background:
- Quantifying upper limb electromyography (EMG) patterns in children with unilateral spastic cerebral palsy (CP) and typically developing children is crucial.
- Comparing different amplitude normalization methods for EMG data is essential for accurate analysis.
- Understanding variability in EMG patterns can help identify deviations and treatment responses in children with CP.
Purpose of the Study:
- To quantify upper limb EMG pattern variability during elbow movements in typically developing children and those with unilateral spastic CP.
- To compare various amplitude normalization methods for EMG data.
- To develop a method for detecting deviations in CP patients' EMG patterns and changes post-treatment.
Main Methods:
- Surface EMG was recorded from upper limb muscles during elbow movements in 12 typically developing children and 6 with unilateral spastic CP.
- The Likelihood method was employed to assess inter-trial, inter-session, and inter-subject variability in EMG patterns.
- A case study evaluated deviations from typically developing patterns and post-treatment changes in a child with CP.
Main Results:
- Normalization by mean peak amplitude resulted in the lowest EMG variability.
- The developed method identified higher muscle activation in specific muscles in children with CP compared to controls.
- The analysis detected a reduction in muscle activation after botulinum toxin A injections.
Conclusions:
- Upper limb surface EMG pattern analysis is a viable tool for clinical applications in children with cerebral palsy.
- This approach can aid in objective assessment of motor function and treatment efficacy in pediatric CP.
- Further research can refine EMG analysis for improved diagnosis and management of CP.
Background:
The aim of this study was two-fold: (1) to quantify the variability of upper limb electromyographic patterns during elbow movements in typically developing children and children with unilateral spastic cerebral palsy, and to compare different amplitude normalization methods; (2) to develop a method using this variability to detect (a) deviations in the patterns of a child with unilateral spastic cerebral palsy from the average patterns of typically developing children, and (b) changes after treatment to reduce muscle activation.
Methods:
Twelve typically developing children ([6.7-15.9yo]; mean 11.0 SD 3.0yo) and six children with unilateral spastic cerebral palsy ([7.9-17.4yo]; mean 12.4 SD 4.0yo) attended two sessions during which they performed elbow extension-flexion and pronation-supination movements. Surface electromyography of the biceps, triceps, brachioradialis, pronator teres, pronator quadratus, and brachialis muscles was recorded. The Likelihood method was used to estimate the inter-trial, inter-session, and inter-subject variability of the electromyography patterns for each time point in the movement cycle. Deviations in muscle patterns from the patterns of typically developing children and changes following treatment were evaluated in a case study of a child with cerebral palsy.
Findings:
Normalization of electromyographic amplitude by the mean peak yielded the lowest variability. The variability data were then used in the case study. This method detected higher levels of activation in specific muscles compared with typically developing children, and a reduction in muscle activation after botulinum toxin A injections.
Interpretation:
Upper limb surface electromyography pattern analysis can be used for clinical applications in children with cerebral palsy.
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