Comparison of the forward and sideways locomotor patterns in children with Cerebral Palsy

Cappellini, Germana; Sylos-Labini, Francesca; Avaltroni, Priscilla; Dewolf, Arthur H.; Assenza, Carla; Morelli, Daniela; Lacquaniti, Francesco; Ivanenko, Yuri P.

doi:10.1038/s41598-023-34369-4

Cited by 3 publications

(1 citation statement)

References 63 publications

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“…In addition to the analysis of muscle synergies, differences in individual EMG patterns have been found in some neurological diseases such as stroke [49,50] and cerebral palsy [50][51][52], for example, but also in PFP [22,53,54]. However, these studies mostly focused on hip and knee muscles and compared differences in the activation onset time between pairs of muscles.…”

Section: Plos Onementioning

confidence: 99%

Muscle synergies analysis shows altered neural strategies in women with patellofemoral pain during walking

Ferreira,

Oliveira Barroso,

Torricelli

et al. 2023

PLoS ONE

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Several studies suggest that the central nervous system coordinates muscle activation by modulating neural commands directed to groups of muscles combined to form muscle synergies. Individuals with patellofemoral pain (PFP) move differently from asymptomatic individuals. Understanding the neural strategies involved in the execution of tasks such as walking can help comprehend how the movement is planned and better understand this clinical condition. The objective of this study was to compare muscle synergies between women with and without PFP during walking. Eleven women with PFP and thirteen asymptomatic women were assessed using three-dimensional kinematics and electromyography (EMG) while walking at self-selected speed. Kinematics of the trunk, pelvis and lower limbs were analyzed through the Movement Deviation Profile. Muscle synergies were extracted from the EMG signals of eight lower limb muscles collected throughout the whole gait cycle. Kinematic differences between the two groups (p<0.001, z-score = 3.06) were more evident during loading response, terminal stance, and pre-swing. PFP group presented a lower number of muscle synergies (p = 0.037), and greater variability accounted for (VAFtotal) when using 3 (p = 0.017), 4 (p = 0.004), and 5 (p = 0.012) synergies to reconstruct all EMG signals. The PFP group also presented higher VAFmuscle for rectus femoris (p = 0.048) and gastrocnemius medialis (p = 0.019) when considering 4 synergies. Our results suggest that women with PFP show lower motor complexity and deficit in muscle coordination to execute gait, indicating that gait in PFP is the result of different neural commands compared to asymptomatic women.

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Section: Plos Onementioning

confidence: 99%

Muscle synergies analysis shows altered neural strategies in women with patellofemoral pain during walking

Ferreira,

Oliveira Barroso,

Torricelli

et al. 2023

PLoS ONE

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Understanding mechanisms of generalization following locomotor adaptation

Rossi,

Roemmich,

Bastian

2024

npj Sci. Learn.

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Our nervous system has the remarkable ability to adapt our gait to accommodate changes in our body or surroundings. However, our adapted walking patterns often generalize only partially (or not at all) between different contexts. Here, we sought to understand how the nervous system generalizes adapted gait patterns from one context to another. Through a series of split-belt treadmill walking experiments, we evaluated different mechanistic hypotheses to explain the partial generalization of adapted gait patterns from split-belt treadmill to overground walking. In support of the credit assignment hypothesis, our experiments revealed the central finding that adaptation involves recalibration of two distinct forward models. Recalibration of the first model generalizes to overground walking, suggesting that the model represents the general movement dynamics of our body. On the other hand, recalibration of the second model does not generalize to overground walking, suggesting the model represents dynamics specific to treadmill walking. These findings reveal that there is a predefined portion of forward model recalibration that generalizes across context, leading to overall partial generalization of walking adaptation.

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The efficiency and use of a reciprocating system aid for standing and walking in children affected by severe cerebral palsy

Avaltroni,

Ivanenko,

Assenza

et al. 2024

Front. Pediatr.

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Cerebral Palsy (CP) is a leading cause of childhood motor disability, making independent walking a crucial therapeutic goal. Robotic assistive devices offer potential to enhance mobility, promoting community engagement and quality of life. This is an observational report of 22 cases of children with CP in which we evaluated the Moonwalker exoskeleton (a dynamic moving aid system) usability, functional changes, and caregivers' perspectives based on the International Classification of Functioning (ICF). All children (aged 2–8 years, with a severe gait impairment and inability to use a conventional walker) underwent Moonwalker training for 20 sessions, followed by home use for five months. Post-treatment, majority of children showed improved endurance assessed by the 10-m walk test with a notable involvement of the upper trunk and arm movements for gait assistance. Many of them achieved rather remarkable results reaching a velocity of ≥0.5 m/s given the constraints of the walking exoskeleton and the children's size, while at admission all children walked at a speed of less than 0.5 m/s. Several positive environmental factors and family adherence were noted, as assessed by ICF in a subgroup of children. This study on a sample of children demonstrated that the Moonwalker exoskeleton allows walking and training at home in children with severe CP, enhancing development, social interaction, and endurance, while being well-received by families.

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Comparison of the forward and sideways locomotor patterns in children with Cerebral Palsy

Cited by 3 publications

References 63 publications

Muscle synergies analysis shows altered neural strategies in women with patellofemoral pain during walking

Muscle synergies analysis shows altered neural strategies in women with patellofemoral pain during walking

Understanding mechanisms of generalization following locomotor adaptation

The efficiency and use of a reciprocating system aid for standing and walking in children affected by severe cerebral palsy

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