The lower limb coordination, brain activation during walking and their correlation in adolescents with spastic...

This study aimed to explore the lower limb coordination and brain activation in adolescents with cerebral palsy (CP) during walking, and to investigate their relationship.

8 adolescents with spastic CP were recruited as the CP group and 8 typically developing (TD) adolescents as the control group. Functional near-infrared spectroscopy (fNIRS) and the Vicon motion capture system were used to collect hemodynamic signals and kinematic data during walking, respectively.

The mean absolute value of the continuous relative phase (MACRP) values of hip-knee joint was lower but deviation phase (DP) values of hip-knee and knee-ankle joints was higher. The activation levels of the supplementary motor area (SMA), the pre-central gyrus (PRG), the post-central gyrus (POG), and the superior parietal lobe (SPL) were higher. The DP of hip-knee joint was positively correlated with the SPL (channels 9,18) and right POG (channel 17), whereas the DP of the knee-ankle joint was positively correlated with the right POG (channel 17). In the control group, the MACRP of knee-ankle joint was positively correlated with the right PRG and POG (channel 15). The DP of hip-knee joint was positively correlated with the right SMA (channel 12) but negatively correlated with the left SPL (channel 9).

Adolescents with CP exhibit a higher variability in hip-knee and knee-ankle joints in the coordination patterns and greater demand for activation of the sensorimotor cortex during walking. The over-activation of the parietal cortex may lead to increased variability in the coordination patterns of individuals with CP.