The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy

Ettema, Sanne; Oudenhoven, Laura M.; Roeleveld, Karin; Buizer, Annemieke I.; Krogt, Marjolein M. van der

doi:10.1016/j.gaitpost.2022.01.004

Cited by 7 publications

(9 citation statements)

References 39 publications

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“…Thus, choice of measure would probably not have affected our results. Our findings showed co-activation indices between 19 and 65 with an average of 39, similar to other studies of muscle co-activation in children with CP [ 19 ]. Our findings are in agreement with the findings of Keefer and co-workers [ 21 ], reporting no relation between thigh muscle co-activation and net VO 2 .…”

Section: Discussionsupporting

confidence: 91%

“…The co-activation index used in the current study weights the total activation, and may thus provide a better measure of the actual co-activity during dynamic tasks with varying muscle activity [ 32 ]. However, regardless of index used, muscle co-activation is reported to be higher in children with CP compared to typically developing peers [ 16 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the excessive lower limb muscle co-activation reported in children with CP during walking [ 16 – 19 ] may also play a role in increased energy expenditure. Muscle co-activation may be defined as concurrent activity of agonist and antagonist muscles crossing the same joint [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

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The relation of energy cost of walking with gait deviation, asymmetry, and lower limb muscle co-activation in children with cerebral palsy: a retrospective cross-sectional study

Gagnat

Brændvik

Ringheim

et al. 2023

BMC Musculoskelet Disord

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Background Compared to typically developing children, children with cerebral palsy (CP) have increased energy expenditure during walking, limiting activity and participation. Insight into whether the also deviating and more asymmetric gait with increased muscle co-activation contributes to this increased energy expenditure is important for clinical decision making. The aim of this study was to investigate the relation between energy cost of walking with gait deviation, asymmetry, and muscle co-activation in children with CP. Methods Forty ambulant children with CP, with Gross Motor Function Classification System (GMFCS) level I (N = 35) and II (N = 5), aged between 5-17y, were tested at one or two occasions with 24 weeks in between, resulting in 71 observations. Gross energy cost (J/kg/m) was measured during a 5-min walk test at self-selected speed. From a 3-dimensional gait analyses, kinematic variables and electromyography were extracted to calculate the gait deviation index (GDI) and co-activation index. The relation between energy cost and GDI, GDI asymmetry, and co-activation index of the lower limb muscles was evaluated through mixed model analyses. Height was included to control for growth-related variation. Results Gait deviation and height combined explained about 40% of the variance in gross energy cost. No significant contribution was found for gait asymmetry or co-activation index. Conclusions This cross-sectional study indicates that increased gait deviation contributes to increased energy cost of walking in children with GMFCS level I and II.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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The relation of energy cost of walking with gait deviation, asymmetry, and lower limb muscle co-activation in children with cerebral palsy: a retrospective cross-sectional study

Gagnat

Brændvik

Ringheim

et al. 2023

BMC Musculoskelet Disord

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“…According to literature ( Table 1 ), gait kinematic and muscles fatigability are not primary driving changes for muscle synergy composition, while the severity of the disease (represented as a high GMFCS level) negatively interferes with the number and composition of the exploited synergies. Indeed, according to many studies, the differences in muscle synergies observed in TD children and children affected by CP are not related to the fatiguability of the muscular tissue nor to impaired biomechanics ( Yu et al, 2019 ; Falisse et al, 2020 ; Ettema et al, 2022 ; Goudriaan et al, 2022 ; Spomer et al, 2022 ). To support the hypothesis, it is noteworthy to consider that different treatment approaches have shown minimal changes in synergies, even if gait pattern, movement quality and speed improved significantly after treatment ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Recent developments in muscle synergy analysis in young people with neurodevelopmental diseases: A Systematic Review

Beltrame

Scano

Marino

et al. 2023

Front. Bioeng. Biotechnol.

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The central nervous system simplifies motor control by sending motor commands activating groups of muscles, known as synergies. Physiological locomotion can be described as a coordinated recruitment of four to five muscle synergies. The first studies on muscle synergies in patients affected by neurological diseases were on stroke survivors. They showed that synergies can be used as biomarkers for motor impairment as they vary in patients with respect to healthy people. Likewise, muscle synergy analysis has been applied to developmental diseases (DD). The need for a comprehensive view of the present findings is crucial for comparing results achieved so far and promote future directions in the field. In the present review, we screened three scientific databases and selected thirty-six papers investigating muscle synergies extracted from locomotion in children affected by DD. Thirty-one articles investigate how cerebral palsy (CP) influences motor control, the currently exploited method in studying motor control in CP and finally the effects of treatments in these patients in terms of synergies and biomechanics; two articles investigate how muscle synergies vary in Duchenne muscular dystrophy (DMD), and three other articles assess other developmental pathologies, such as chronic and acute neuropathic pain. For CP, most of the studies demonstrate that the number of synergies is lower and that the synergy composition varies in the affected children with respect to normal controls. Still, the predictability of treatment’s effects and the etiology of muscle synergy variation are open questions, as it has been reported that treatments minimally modify synergies, even if they improve biomechanics. The application of different algorithms in extracting synergies might bring about more subtle differences. Considering DMD, no correlation was found between non-neural muscle weakness and muscle modules’ variation, while in chronic pain a decreased number of synergies was observed as a possible consequence of plastic adaptations. Even if the potential of the synergistic approach for clinical and rehabilitation practices is recognized, there is not full consensus on protocols nor widely accepted guidelines for the systematic clinical adoption of the method in DD. We critically commented on the current findings, on the methodological issues and the relative open points, and on the clinical impact of muscle synergies in neurodevelopmental diseases to fill the gap for applying the method in clinical practice.

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“…A análise conjunta da frequência mediana e da atividade ao longo de uma tarefa tem se mostrado útil na análise da fisiologia muscular. Assim, um decréscimo na frequência mediana associado a um aumento da atividade EMG têm sido usados como medida indireta de fadiga muscular (Ettema et al, 2022).…”

Section: Diadococinesia Oralunclassified

Condição miofuncional e controle motor orofacial em crianças com apneia obstrutiva do sono

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Ao Rafael, meu amado filho e minha razão de viver. É por você que todos os dias eu agradeço! Aos meus queridos pais, Francisco e Ana Paula, que desde pequena me dizem que minha maior herança seria os meus estudos e investiram nisso e vibram comigo em todas as conquistas. À minha orientadora, Cláudia, sem a qual não teria conseguido concluir essa jornada. A vocês, dedico este trabalho! AGRADECIMENTOS Agradecer é uma virtude. É dever de quem termina uma jornada, uma vez que caminho algum se trilha sozinho. Assim sendo... Agradeço a Deus, por me dar tantas e lindas graças: a da vida, da família, a de ter pessoas amadas ao meu lado, a de poder aprender com erros e acertos, a de valorizar cada momento de saúde, a de poder escrever e finalizar mais um capítulo da minha vida. Por me carregar no colo quando achei que não conseguiria mais caminhar sozinha. Ao meu esposo, Luiz Fernando, não há como expressar minha gratidão por tudo o que você é para mim. Sua paciência, apoio, carinho, parceria e cumplicidade trazem sentido e direção para minha jornada. Obrigada por dividir sonhos, sorrisos e lágrimas. Por dividir a vida. Por acreditar que eu conseguiria até quando eu mesma duvidei. Por ser um pai incrível para nosso menino. Eu te amo muito! Ao meu amado filho, Rafael, presente de Deus em minha vida, que me ensina diariamente a mais poderosa e singela forma de amar. Que você se inspire na minha persistência, esforço e trabalho para concluir esta tese. E colha os frutos. E tenha a sensação da vitória e da missão cumprida. Você é o meu tesouro, a minha alegria de viver, o meu pequeno pedaço do Paraíso, o meu orgulho, o meu amor! Te amo além da vida! Aos meus pais, Francisco e Ana Paula, por me ensinarem que a vida pode ser feita de sonhos e que mesmo com grandes dificuldades, posso alcançá-los com amor, honestidade, dedicação e trabalho. Aqui está o resultado dos seus esforços e empenho em me educar. Ter concluído essa etapa só foi possível por suas orações e apoio. Amo vocês! Aos meus irmãos, Felipe e Gabriel, e às minhas cunhadas, Carolina e Lívia, compartilhar minhas conquistas com vocês e ver a verdadeira felicidade em seus olhos são troféus que levo comigo. Obrigada pela companhia de sempre, risadas e lágrimas compartilhadas. Não sei o que seria de mim sem vocês! Amo vocês! À minha orientadora, Profa. Dra. Cláudia Maria de Felício, que me aceitou como orientanda desde 2009, no meu segundo ano de graduação, me proporcionando a vivência no LISE e me despertando a vontade de continuar na trajetória acadêmica. Toda minha gratidão à senhora pela grande atenção e esforços dispensados que se tornaram essenciais para que essa tese fosse concluída. Agradeço aos professores que me acompanharam ao longo do meu percurso e que, com empenho, se dedicam à arte de ensinar. Em especial, Profa. Dra.

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The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy

Cited by 7 publications

References 39 publications

The relation of energy cost of walking with gait deviation, asymmetry, and lower limb muscle co-activation in children with cerebral palsy: a retrospective cross-sectional study

The relation of energy cost of walking with gait deviation, asymmetry, and lower limb muscle co-activation in children with cerebral palsy: a retrospective cross-sectional study

Recent developments in muscle synergy analysis in young people with neurodevelopmental diseases: A Systematic Review

Condição miofuncional e controle motor orofacial em crianças com apneia obstrutiva do sono

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