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Published on: November 3, 2016
Neuromuscular Control before and after Independent Walking Onset in Children with Cerebral Palsy
Annike Bekius1,2, Coen S Zandvoort1, Jennifer N Kerkman1
1Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands.
Insights
Children with cerebral palsy (CP) show altered neuromuscular control, using fewer muscle synergies for walking compared to typically developing peers. These differences emerge early, even before independent walking, and are more pronounced on the affected side in asymmetric CP.
Area of Science:
- Neurology
- Developmental Pediatrics
- Biomedical Engineering
Background:
- Early brain lesions are a primary cause of cerebral palsy (CP), impacting motor development, particularly walking.
- Neuromuscular control development in young children with CP versus typically developing (TD) children remains unclear, especially regarding muscle synergy analysis before and after independent walking onset.
Purpose of the Study:
- To investigate differences in muscle synergy recruitment and structure between young children with CP and TD children.
- To compare neuromuscular control strategies in supported versus independent walking stages in both CP and TD groups.
- To identify side-specific alterations in neuromuscular control for children with asymmetric CP.
Main Methods:
- Muscle synergies were extracted from electromyography data of bilateral leg muscles using non-negative matrix factorization (NMF).
- Twenty children with (high risk of) CP and twenty TD children (6.5-52.4 months) were grouped by walking ability (supported or independent).
- Number of synergies, their structure, and variability (VAF1, VAF2) were compared between CP and TD groups.
Main Results:
- Children with CP recruited fewer muscle synergies with higher variability accounted for (VAF1, VAF2) compared to TD children across both supported and independent walking stages.
- In asymmetric CP, the most affected limb recruited fewer synergies with higher VAF1 compared to the less affected limb during independent walking.
- These findings indicate early alterations in neuromuscular control in children with CP.
Conclusions:
- Early brain lesions leading to CP cause distinct alterations in neuromuscular control strategies for walking.
- Muscle synergy analysis reveals that children with CP utilize a less diverse set of motor patterns.
- The observed differences are specific to the affected side in asymmetric CP, highlighting the impact of lesion laterality on motor control development.
Abstract:
Early brain lesions which produce cerebral palsy (CP) may affect the development of walking. It is unclear whether or how neuromuscular control, as evaluated by muscle synergy analysis, differs in young children with CP compared to typically developing (TD) children with the same walking ability, before and after the onset of independent walking. Here we grouped twenty children with (high risk of) CP and twenty TD children (age 6.5-52.4 months) based on their walking ability, supported or independent walking. Muscle synergies were extracted from electromyography data of bilateral leg muscles using non-negative matrix factorization. Number, synergies' structure and variability accounted for when extracting one (VAF1) or two (VAF2) synergies were compared between CP and TD. Children in the CP group recruited fewer synergies with higher VAF1 and VAF2 compared to TD children in the supported and independent walking group. The most affected side in children with asymmetric CP walking independently recruited fewer synergies with higher VAF1 compared to the least affected side. Our findings suggest that early brain lesions result in early alterations of neuromuscular control, specific for the most affected side in asymmetric CP.
