The impact of ankle-foot orthotics on selective motor control during gait in children and adolescents with cerebral palsy

被引:0
作者
Keren, Dan [1 ,3 ]
Goudriaan, Marije [4 ,5 ,6 ,7 ]
Springer, Shmuel [3 ]
Sorek, Gilad [1 ]
Dominici, Nadia [4 ,5 ,8 ]
van der Krogt, Marjolein M. [7 ,8 ]
Buizer, Annemieke I. [7 ,8 ,9 ]
Schless, Simon-Henri [1 ,2 ]
机构
[1] ALYN Hosp, Helmsley Pediat & Adolescent Rehabil Res Ctr PARC, Jerusalem, Israel
[2] ALYN Pediat & Adolescent Rehabil Ctr, Clin Mot Anal Lab, Jerusalem, Israel
[3] Ariel Univ, Fac Hlth Sci, Dept Phys Therapy, Neuromuscular & Human Performance Lab, Ariel, Israel
[4] Vrije Univ Amsterdam, Fac Behav & Movement Sci, Dept Human Movement Sci, Amsterdam, Netherlands
[5] Vrije Univ Amsterdam, Inst Brain & Behav Amsterdam, Amsterdam, Netherlands
[6] Univ Utrecht, Univ Corp Off Student & Acad Affairs, Utrecht, Netherlands
[7] Vrije Univ Amsterdam, Dept Rehabil Med, Amsterdam UMC Locat, Amsterdam, Netherlands
[8] Amsterdam Movement Sci, Rehabil & Dev, Amsterdam, Netherlands
[9] Emma Childrens Hosp, Amsterdam UMC, Amsterdam, Netherlands
基金
欧洲研究理事会;
关键词
Cerebral palsy; Muscle synergies; Ankle-foot orthoses; Joint kinematics; Gait; MUSCLE SYNERGIES; WALKING; ORTHOSES; REPEATABILITY; EFFICACY;
D O I
10.1016/j.gaitpost.2024.08.079
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Children with cerebral palsy (CP) often exhibit altered selective motor control during gait (SMCg). Ankle-foot-orthoses (AFOs) are used in this population to improve gait, by reducing the degrees of freedom at the ankle joint. However, the specific impact of AFOs on SMCg and whether this effect is more related to gait deviations or motor development remains unclear. Research question: Do AFOs impact SMCg, and is the change related to joint kinematics or age? Methods: Gait analysis data from 53 children and adolescents with spastic CP, walking both barefoot and with AFOs, were included. Electromyography data from six lower-limb muscles, and lower limb joint kinematics were analyzed for both walking conditions. SMCg was quantified by the total variance in electromyography activity accounted for by one synergy (tVAF1), where an increase in tVAF1 indicates a decrease in SMCg. Kinematic gait deviation was assessed using the Gait-Profile-Score (GPS) and sagittal plane ankle Gait-Variable-Score (ankleGVS). All analyses were performed for the more clinically involved leg only. Results: Walking with AFOs resulted in a mean increase in tVAF1 of 0.02 +/- 0.07 (p=0.015) and a median increase in ankle-GVS of 3.4 degrees (p>0.001). No significant changes were observed in GPS, and no correlation was found between the changes in tVAF1 and ankle-GVS. A significant positive moderate correlation was found between the change in tVAF1 and age, even with ankle-GVS as a covariate (r=0.45; p>0.001). Significance: Walking with an AFO resulted in a small decrease in SMCg, with large inter-participant variability. Younger participants showed a greater decrease in SMCg, which may indicate greater neuromuscular plasticity in early developmental stages.
引用
收藏
页码:48 / 54
页数:7
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