Does spasticity affect the postural stability and quality of life of children with cerebral palsy?

Ali, Mostafa S.

doi:10.1016/j.jtumed.2021.04.011

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…Postural control during walking can be indicative of underlying health problems. The body’s postural control significantly impacts the quality of life [ 29 , 30 ]. Using wearable devices to measure posture can be inconvenient for participants [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Integrating OpenPose and SVM for Quantitative Postural Analysis in Young Adults: A Temporal-Spatial Approach

Lee,

Chen,

Lin

et al. 2024

Bioengineering

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Noninvasive tracking devices are widely used to monitor real-time posture. Yet significant potential exists to enhance postural control quantification through walking videos. This study advances computational science by integrating OpenPose with a Support Vector Machine (SVM) to perform highly accurate and robust postural analysis, marking a substantial improvement over traditional methods which often rely on invasive sensors. Utilizing OpenPose-based deep learning, we generated Dynamic Joint Nodes Plots (DJNP) and iso-block postural identity images for 35 young adults in controlled walking experiments. Through Temporal and Spatial Regression (TSR) models, key features were extracted for SVM classification, enabling the distinction between various walking behaviors. This approach resulted in an overall accuracy of 0.990 and a Kappa index of 0.985. Cutting points for the ratio of top angles (TAR) and the ratio of bottom angles (BAR) effectively differentiated between left and right skews with AUC values of 0.772 and 0.775, respectively. These results demonstrate the efficacy of integrating OpenPose with SVM, providing more precise, real-time analysis without invasive sensors. Future work will focus on expanding this method to a broader demographic, including individuals with gait abnormalities, to validate its effectiveness across diverse clinical conditions. Furthermore, we plan to explore the integration of alternative machine learning models, such as deep neural networks, enhancing the system’s robustness and adaptability for complex dynamic environments. This research opens new avenues for clinical applications, particularly in rehabilitation and sports science, promising to revolutionize noninvasive postural analysis.

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Section: Discussionmentioning

confidence: 99%

Integrating OpenPose and SVM for Quantitative Postural Analysis in Young Adults: A Temporal-Spatial Approach

Lee,

Chen,

Lin

et al. 2024

Bioengineering

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“…Previous research has mainly focused on the relation between spasticity or reflex hyper-excitability and muscle activity during walking (Nielsen et al, 2020). Only two prior studies specifically investigated reactive standing balance and found no relation between joint hyper-resistance as measured by MAS and CoM movement (Ali, 2021) or the ability to withstand perturbations without stepping (de Niet et al, 2013). In contrast to prior studies, we did not only assess general resistance or the neural response to muscle stretch but also muscle co-activation, as a sign of reduced reciprocal inhibition.…”

Section: Discussionmentioning

confidence: 99%

“…Two prior studies investigated the relationship between joint hyper-resistance and reactive standing balance. These studies found no relationship between the Modified Ashworth Scale (MAS) and respectively CoM movement during standing in children with CP (Ali, 2021) and the ability to withstand perturbations without stepping in children with hereditary spastic paraparesis (de Niet et al, 2013). To our knowledge, the relationship between reduced reciprocal inhibition in response to isolated joint rotations and increased muscle co-activation during functional movements has not been studied.…”

Section: Introductionmentioning

confidence: 96%

Reduced reciprocal inhibition during clinical tests of spasticity is associated with impaired reactive standing balance control in children with cerebral palsy

Willaert,

Ting,

Van Campenhout

et al. 2023

Preprint

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BackgroundJoint hyper-resistance is a common symptom in cerebral palsy (CP). It is assessed by rotating the joint of a relaxed patient. Joint rotations also occur when perturbing functional movements. Therefore, joint hyper-resistance might contribute to reactive balance impairments in CP.AimTo investigate relationships between altered muscle responses to isolated joint rotations and perturbations of standing balance in children with CP.Methods & procedures20 children with CP participated in the study. During an instrumented spasticity assessment, the ankle was rotated as fast as possible from maximal plantarflexion towards maximal dorsiflexion. Standing balance was perturbed by backward support-surface translations and toe-up support-surface rotations. Gastrocnemius, soleus, and tibialis anterior electromyography was measured. We quantified reduced reciprocal inhibition by plantarflexor-dorsiflexor co-activation and the neural response to stretch by average muscle activity. We evaluated the relation between muscle responses to ankle rotation and balance perturbations using linear mixed models.Outcomes & resultsCo-activation during isolated joint rotations and perturbations of standing balance was correlated across all levels. The neural response to stretch during isolated joint rotations and balance perturbations was not correlated.Conclusions & implicationsReduced reciprocal inhibition during isolated joint rotations might be a predictor of altered reactive balance control strategies.HighlightsImpaired reciprocal inhibition might underlie altered balance control in CP.Co-activation during isolated joint rotations and balance responses is correlated.Hyperreflexia is not correlated with increased response to perturbations of standing.Reduced reciprocal inhibition has functional implications.It might be valuable to clinically assess reduced reciprocal inhibition.What this paper addsIt has been hard to relate alterations in muscle coordination during functional movements to alterations in the muscle’s response to isolated joint rotations as applied during (clinical) assessments of hyper-reflexia. Here, we performed a more comprehensive assessment of the altered muscle response to isolated joint rotations in children with cerebral palsy (CP) by not only considering muscle activity in response to stretch but also agonist-antagonist co-activation. Muscle co-activation in response to isolated joint rotations in relaxed patients has been attributed to reduced reciprocal inhibition in the spinal cord. We found that muscle co-activation during isolated joint rotations was correlated to muscle co-activation during perturbed standing, an important functional movement. Therefore, increased muscle co-activation during standing balance control might – at least partially – result from reduced reciprocal inhibition in the spinal cord. In contrast, we found very few relations between the mean muscle activity during isolated joint rotations and perturbed standing. This might be due to the sensitivity of the response to stretch to stretch velocity, posture, and baseline muscle activity, all of which largely differed between the two conditions. Our results indicate that clinical assessment of reduced reciprocal inhibition during isolated joint rotations might provide information about balance impairments.

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“…Children with spastic diplegic CP often exhibit a greater degree of impairment in the lower extremities compared to other regions of the body. This typically manifests as challenges in maintaining an upright posture of the trunk due to the inherent instability caused by a high center of mass and a limited base of support (3) . It was demonstrated that children with spastic diplegic CP had worse trunk control and maintaining balance than typically developing children.…”

Section: Introductionmentioning

confidence: 99%

Effect of Weighted Vest on Gross Motor Function and Balance in Children with Spastic Cerebral Palsy

2024

The Egyptian Journal of Hospital Medicine

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Background: High muscle tension in children with CP causes unstable posture and mobility. The weighted vest was used as an intervention tool that provides weight resistance while applying the exercise program to children with disabilities. Purpose:The study was conducted to examine the impact of the weighted vest on gross motor functions as well as balance abilities in children suffering from spastic diplegia. Patients and Methods: Thirty children, ranging in age from four to seven, suffering from spastic diplegia were involved in this study. They were divided into two equal groups utilizing random assignment. The participated children in both groups were given designed physiotherapy program. The study group was given the same physiotherapy program while wearing the weighted vest. The treatment program for the two groups was conducted for 3 times a week for 3 consecutive months. The gross motor function and balance of all participated children in both groups were measured by gross motor function measure (GMFM) as well as pediatric balance scale (PBS) respectively. Results: There was significant improvement in both groups in the gross motor function as well as balance abilities post-treatment. When comparing post-treatment for both groups, the results showed a significant improvement favoring the study group. Conclusion: This prospective study demonstrated beneficial effects of three months of physical therapy exercises, while wearing the weighted vest on gross motor abilities and balance in children with diplegia.

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Does spasticity affect the postural stability and quality of life of children with cerebral palsy?

Cited by 5 publications

References 36 publications

Integrating OpenPose and SVM for Quantitative Postural Analysis in Young Adults: A Temporal-Spatial Approach

Integrating OpenPose and SVM for Quantitative Postural Analysis in Young Adults: A Temporal-Spatial Approach

Reduced reciprocal inhibition during clinical tests of spasticity is associated with impaired reactive standing balance control in children with cerebral palsy

Effect of Weighted Vest on Gross Motor Function and Balance in Children with Spastic Cerebral Palsy

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