Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy

Ropars, Juliette; Lempereur, Mathieu; Vuillerot, Carole; Tiffreau, V.; Peudenier, Sylviane; Cuisset, Jean‐Marie; Péreón, Yann; Leboeuf, Fabien; Delporte, Ludovic; Delpierre, Y.; Gross, Raphaël; Brochard, Sylvain

doi:10.1371/journal.pone.0161938

Cited by 32 publications

(30 citation statements)

References 36 publications

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“…Since the REF is not one of the prime movers of synergy one, the increased REF weights suggest an increase in level of co-contraction during loading response and at the end of swing phase. This is in line with the findings of Ropars et al (2016), who reported increased coactivation of the REF and MEH during gait in children with DMD of a similar age. The quadriceps is one of the first muscle groups that starts to deteriorate and is characterized by muscle atrophy [3,44].…”

Section: Discussionsupporting

confidence: 93%

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

et al. 2020

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Our aim was to determine if synergy weights and activations are altered in Duchenne muscular dystrophy (DMD) and if these alterations could be linked to muscle weakness. Methods In 22 children with DMD and 22 typical developing (TD) children of a similar age, surface electromyography (sEMG) of the gluteus medius, rectus femoris (REF), medial hamstrings, tibialis anterior, and medial gastrocnemius (GAS) were recorded during gait. Muscle weakness was assessed with maximal voluntary isometric contractions (MVIC). Synergies were calculated with non-negative matrix factorization. The number of synergies explaining �90% of the variance in the sEMG signals (N90), were extracted and grouped with k-means cluster analysis. We verified differences in weights with a Mann-Whitney U test. Statistical non-parametric mapping (Hotelling's T 2 test and two-tailed t-test) was used to assess group differences in synergy activations. We used Spearman's rank correlation coefficients and canonical correlation analysis to assess if weakness was related to modifications in weights and activations, respectively. Results For both groups, average N90 was three. In synergy one, characterized by activity at the beginning of stance, the DMDs showed an increased REF weight (p = 0.001) and decreased GAS weight (p = 0.007). Synergy activations were similar, with only a small difference detected in mid-swing in the combined activations (p<0.001). Weakness was not associated with these differences.

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Section: Discussionsupporting

confidence: 93%

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

et al. 2020

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Section: Introductionmentioning

confidence: 99%

“…There are only a small number of studies describing DMD gait (Sutherland et al, 1981 ; D'Angelo et al, 2009 ; Gaudreault et al, 2010 ; Doglio et al, 2011 ; Ganea et al, 2012 ; Ropars et al, 2016 ). Furthermore, none of these studies have verified to what extent these gait deviations were associated with muscle weakness (Sutherland et al, 1981 ; D'Angelo et al, 2009 ; Gaudreault et al, 2010 ; Doglio et al, 2011 ; Ganea et al, 2012 ; Ropars et al, 2016 ). In CP, several researchers have analyzed the relationship between muscle weakness and gait impairments, but their results are inconsistent (Damiano et al, 1995 , 2010 ; Wiley and Damiano, 1998 ; Desloovere et al, 2006 ; Lee et al, 2008 ; Dallmeijer et al, 2011 ; Eek et al, 2011 ; Sagawa et al, 2013 ; Meyns et al, 2016 ; Shin et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Non-neural Muscle Weakness Has Limited Influence on Complexity of Motor Control during Gait

Goudriaan

Shuman

Steele

et al. 2018

Front. Hum. Neurosci.

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Cerebral palsy (CP) and Duchenne muscular dystrophy (DMD) are neuromuscular disorders characterized by muscle weakness. Weakness in CP has neural and non-neural components, whereas in DMD, weakness can be considered as a predominantly non-neural problem. Despite the different underlying causes, weakness is a constraint for the central nervous system when controlling gait. CP demonstrates decreased complexity of motor control during gait from muscle synergy analysis, which is reflected by a higher total variance accounted for by one synergy (tVAF1). However, it remains unclear if weakness directly contributes to higher tVAF1 in CP, or whether altered tVAF1 reflects mainly neural impairments. If muscle weakness directly contributes to higher tVAF1, then tVAF1 should also be increased in DMD. To examine the etiology of increased tVAF1, muscle activity data of gluteus medius, rectus femoris, medial hamstrings, medial gastrocnemius, and tibialis anterior were measured at self-selected walking speed, and strength data from knee extensors, knee flexors, dorsiflexors and plantar flexors, were analyzed in 15 children with CP [median (IQR) age: 8.9 (2.2)], 15 boys with DMD [8.7 (3.1)], and 15 typical developing (TD) children [8.6 (2.7)]. We computed tVAF1 from 10 concatenated steps with non-negative matrix factorization, and compared tVAF1 between the three groups with a Mann-Whiney U-test. Spearman's rank correlation coefficients were used to determine if weakness in specific muscle groups contributed to altered tVAF1. No significant differences in tVAF1 were found between DMD [tVAF1: 0.60 (0.07)] and TD children [0.65 (0.07)], while tVAF1 was significantly higher in CP [(0.74 (0.09)] than in the other groups (both p < 0.005). In CP, weakness in the plantar flexors was related to higher tVAF1 (r = −0.72). In DMD, knee extensor weakness related to increased tVAF1 (r = −0.50). These results suggest that the non-neural weakness in DMD had limited influence on complexity of motor control during gait and that the higher tVAF1 in children with CP is mainly related to neural impairments caused by the brain lesion.

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“…Children will sit in a standardized seat at a table and will be asked to perform two reach-to-grasp tasks. Spatio-temporal and kinematic parameters will be calculated along with muscle activation indices such as the Arm Profile Score [55] and the EMG-Profile Score for UE motion [56].…”

Section: Movement Parameters (T0 and T2)mentioning

confidence: 99%

Functional, neuroplastic and biomechanical changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with unilateral cerebral palsy: study protocol of a randomized control trial

Araneda¹,

Sizonenko²,

Newman³

et al. 2020

BMC Neurol

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Background: Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in preschool children with unilateral CP on functional, neuroplastic and biomechanical parameters.

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Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy

Cited by 32 publications

References 36 publications

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

Non-neural Muscle Weakness Has Limited Influence on Complexity of Motor Control during Gait

Functional, neuroplastic and biomechanical changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with unilateral cerebral palsy: study protocol of a randomized control trial

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