Assessment by Surface Electromyography in International Football Players with Cerebral Palsy-A Pilot Study

Background: In para-sports, like Cerebral Palsy (CP) Football, athletes must meet a minimum impairment level to ensure fair competition. The classification process traditionally relies on subjective tools like the modified Ashworth Scale, but there is a need for more objective methods. Surface electromyography (EMG) offers quantifiable data on muscle activation, which could enhance the accuracy and fairness of classification in this sport. Objective: The aim of this study is to analyze muscle activation patterns in international CP football players compared to healthy controls, using surface electromyography (EMG). Methods: A cross-sectional, observational case-control study (following STROBE guidelines) was carried out. The final sample consisted of 40 subjects (20 subjects with CP from the Spanish National Team and 20 semi-professional able-bodied football players). The muscle activation of the soleus, adductor magnus, and biceps femoris was evaluated at baseline and in maximum isometric contraction in both dominant/unaffected and non-dominant/affected lower limbs. Results: The main result of this study was that the affected lower limbs of the experimental group showed higher muscle activation at baseline compared to those of the control group (p < 0.001). On the other hand, when a maximum isometric contraction was requested, muscle activation was greater in the control group in both lower limbs. There was greater asymmetry between both muscle groups in the experimental group. Conclusions: Surface electromyography could be a useful tool to be used in the assessment of muscle activity in subjects with CP with an applicability in para-sport, making it possible to obtain differences between both hemispheres when there is upper motor neuron involvement.