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Muscle synergy structure and gait patterns in children with spastic cerebral palsy
Marije Goudriaan1, Eirini Papageorgiou2,3, Benjamin R Shuman4,5
1Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Insights
Muscle synergy structure is similar across different gait patterns in children with spastic cerebral palsy (CP). However, muscle weight differences and high variability suggest individualized motor control strategies based on impairment level.
Area of Science:
- Neurology
- Biomechanics
- Pediatrics
Background:
- Cerebral palsy (CP) often leads to altered gait patterns.
- Understanding muscle synergy is crucial for gait analysis in CP.
- Muscle synergies represent fundamental motor control strategies.
Purpose of the Study:
- To investigate differences in muscle synergy structure (activations and weights) among various gait patterns in children with spastic CP.
- To determine if a common motor control strategy exists across different CP gait patterns.
Main Methods:
- A cross-sectional study involving 188 children with spastic CP.
- Classification of participants into distinct gait patterns (e.g., minor deviations, drop foot, genu recurvatum, apparent equinus, crouch, jump gait).
- Analysis of surface electromyography data from eight lower limb muscles using weighted non-negative matrix factorization to compute muscle synergies.
Main Results:
- Overall muscle synergy structure showed similarity across different gait patterns.
- Differences in muscle synergy weights were observed in more impaired gait patterns (crouch and jump gait) compared to others.
- High variability in muscle synergy structure was noted among participants.
Conclusions:
- The findings suggest a generic motor control strategy employed by children with CP to compensate for neurological deficits.
- Individualized motor control strategies and impairment level influence muscle synergy weights.
- Further research into personalized rehabilitation approaches for CP gait is warranted.
Aim:
To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP).
Method:
In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo-17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization. We compared synergy activations and weights between the patterns.
Results:
Synergy structure was similar between gait patterns, although weights differed in the more impaired children (crouch and jump gait) when compared to the other patterns. Variability in synergy structure between participants was high.
Interpretation:
The similarity in synergy structure between gait patterns suggests a generic motor control strategy to compensate for the brain lesion. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level.
