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Published on: January 11, 2016
Walking Environment and Speed Differentially Change More Affected Limb Dynamic Motor Control in Children With
Stephanie N Mace1, Joseph W Harrington1, Vivek Dutt2
1Department of Biomechanics, University of Nebraska Omaha, USA.
Insights
Aquatic environments and slow speeds enhance neuromuscular control in children with cerebral palsy (CP) during walking. This suggests new rehabilitation strategies focusing on these conditions for improved motor function.
Area of Science:
- Neurology
- Biomechanics
- Rehabilitation Science
Background:
- Children with cerebral palsy (CP) exhibit impaired motor and simplified neuromuscular control during walking.
- Current interventions offer limited improvements in muscle synergies, necessitating novel approaches for motor control enhancement.
Purpose of the Study:
- To evaluate the acute effects of different walking environments and speeds on the neuromuscular control of the more-affected limb in children with CP.
Main Methods:
- Eight children with CP and 15 typically developing children participated.
- Surface electromyography (EMG) sensors measured lower limb muscle activity.
- Non-negative matrix factorization calculated muscle synergies to define dynamic motor control during walking (walk-DMC) across overground, conventional treadmill, and aquatic treadmill conditions.
Main Results:
- The aquatic environment and slow walking speed significantly increased walk-DMC in children with CP, indicating greater neuromuscular complexity.
- Overground and conventional treadmill walking did not significantly alter walk-DMC scores.
Conclusions:
- Dynamic motor control during walking (walk-DMC) in children with CP is sensitive to acute changes in environment and speed.
- Findings suggest aquatic gait rehabilitation, particularly aquatic treadmill training at slow speeds, warrants further investigation for potential therapeutic benefits.
Background:
Children with cerebral palsy (CP) have impaired motor and simplified neuromuscular control during walking. Surgical interventions, conventional therapies, and real-time biofeedback result in minimal improvements in muscle synergies, highlighting the need for new strategies to enhance motor control.
Objective:
To assess how neuromuscular control of the more-affected limb is acutely affected across walking environments and speeds for children with CP.
Method:
Eight children with CP (5 males and 3 females; age: 12.58 ± 3.91 years; height: 1.52 ± 0.20 m; and weight: 54.55 ± 30.83 kg) and 15 typically developing children had 8 surface EMG sensors on the lower limbs. Muscle synergies were calculated with non-negative matrix factorization to define dynamic motor control during walking (walk-DMC) for overground, conventional treadmill, and aquatic treadmill walking. We compared walk-DMC across environment and speed conditions (slow, normal, and fast) for the more-affected limb.
Results:
Main effects of the aquatic environment and the slow walking speed acutely increased walk-DMC in children with CP, indicating increased neuromuscular complexity. Neither conventional treadmill nor overground environments significantly impacted walk-DMC scores.
Conclusions:
Walk-DMC was sensitive to acute changes in the walking environment and speed in children with CP. These findings offer new perspectives on walking rehabilitation by accounting for the interplay between task demands and motor function. However, future studies should investigate repeated exposures to aquatic gait rehabilitation environments, particularly aquatic treadmill training and slow walking speeds.
