Modular Control of Crouch Gait in Spastic Cerebral Palsy

Torricelli, Diego; Pajaro, M.; Lerma, S.; Márquez, E. Arranz; Mastro-Martínez, Ignacio; Barroso, Filipe O.; Pons, José L

doi:10.1007/978-3-319-00846-2_424

Cited by 5 publications

(15 citation statements)

References 4 publications

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“…Results of the methodological quality assessment are presented in Table 2 . Eight studies used a cross-sectional design (Torricelli et al, 2014 ; Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Goudriaan et al, 2018 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ), four used case-control designs (Steele et al, 2015 , 2019 ; Shuman et al, 2016 , 2017 ), and four were retrospective cohort studies (Schwartz et al, 2016 ; Shuman et al, 2018 , 2019 ; Oudenhoven et al, 2019 ). Quality scores ranged from 5 to 13, one study received the grade “poor” (Torricelli et al, 2014 ), ten studies “fair” (Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Shuman et al, 2016 , 2018 , 2019 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Steele et al, 2019 ; Yu et al, 2019 ), three studies “good” (Steele et al, 2015 ; Shuman et al, 2017 ; Goudriaan et al, 2018 ), and two studies “excellent” (Schwartz et al, 2016 ; Oudenhoven et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve of the 16 studies included in this review reported the total number of synergies during walking using a certain VAF threshold (Torricelli et al, 2014 ; Steele et al, 2015 , 2019 ; Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Shuman et al, 2017 , 2019 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Oudenhoven et al, 2019 ; Yu et al, 2019 ). Out of these articles, nine compared the number of synergies between individuals with CP and unimpaired individuals (Steele et al, 2015 ; Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Shuman et al, 2017 , 2019 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ), while the remaining three only included children with CP in their study (Torricelli et al, 2014 ; Oudenhoven et al, 2019 ; Steele et al, 2019 ). Despite a difference in VAF threshold, number of subjects, and number of recorded muscles (see Table 3 ), the majority of studies found that children with CP recruited fewer synergies (range 1–4) compared to TD children (range 3–4) or healthy adults (all 4) on average when comparing the number of synergies during walking (Torricelli et al, 2014 ; Steele et al, 2015 ; Tang et al, 2015 ; Shuman et al, 2017 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…Out of these articles, nine compared the number of synergies between individuals with CP and unimpaired individuals (Steele et al, 2015 ; Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Shuman et al, 2017 , 2019 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ), while the remaining three only included children with CP in their study (Torricelli et al, 2014 ; Oudenhoven et al, 2019 ; Steele et al, 2019 ). Despite a difference in VAF threshold, number of subjects, and number of recorded muscles (see Table 3 ), the majority of studies found that children with CP recruited fewer synergies (range 1–4) compared to TD children (range 3–4) or healthy adults (all 4) on average when comparing the number of synergies during walking (Torricelli et al, 2014 ; Steele et al, 2015 ; Tang et al, 2015 ; Shuman et al, 2017 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ). In contrast, Cappellini et al ( 2016 , 2018 ) found that both children with CP and TD children recruited 4 synergies.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies compared the structure of synergies in terms of the results on temporal and spatial patterns between children with CP and controls (Torricelli et al, 2014 ; Steele et al, 2015 ; Tang et al, 2015 ; Cappellini et al, 2016 , 2018 ; Kim Y. et al, 2018 ; Shuman et al, 2019 ; Yu et al, 2019 ). Two studies found that the spatial structure of synergies of children with CP was different from healthy adults (“mature synergies;” Torricelli et al, 2014 ; Tang et al, 2015 ), as was assessed by Tang et al ( 2015 ) using a model called synergy comprehensive assessment. In addition, Tang et al ( 2015 ) showed that the spatial structure of synergies in children with CP was different from TD children, and that a large variation in synergy structure was present in the CP group.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies found that children with CP recruit fewer synergies during walking compared to TD children, either based on a certain VAF threshold, VAF 1 , or walk-DMC (Torricelli et al, 2014 ; Steele et al, 2015 , 2019 ; Tang et al, 2015 ; Schwartz et al, 2016 ; Shuman et al, 2016 , 2017 , 2018 , 2019 ; Goudriaan et al, 2018 ; Hashiguchi et al, 2018 ; Kim Y. et al, 2018 ; Yu et al, 2019 ). The authors of these studies suggest that neuromotor control is altered or less complex in children with CP.…”

Section: Discussionmentioning

confidence: 99%

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Muscle Synergies During Walking in Children With Cerebral Palsy: A Systematic Review

et al. 2020

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Background: Walking problems in children with cerebral palsy (CP) can in part be explained by limited selective motor control. Muscle synergy analysis is increasingly used to quantify altered neuromuscular control during walking. The early brain injury in children with CP may lead to a different development of muscle synergies compared to typically developing (TD) children, which might characterize the abnormal walking patterns. Objective: The overarching aim of this review is to give an overview of the existing studies investigating muscle synergies during walking in children with CP compared to TD children. The main focus is on how muscle synergies differ between children with CP and TD children, and we examine the potential of muscle synergies as a measure to quantify and predict treatment outcomes. Methods: Bibliographic databases were searched by two independent reviewers up to 22 April 2019. Studies were included if the focus was on muscle synergies of the lower limbs during walking, obtained by a matrix factorization algorithm, in children with CP. Results: The majority (n = 12) of the 16 included studies found that children with CP recruited fewer muscle synergies during walking compared to TD children, and several studies (n = 8) showed that either the spatial or temporal structure of the muscle synergies differed between children with CP and TD children. Variability within and between subjects was larger in children with CP than in TD children, especially in more involved children. Muscle synergy characteristics before treatments to improve walking function could predict treatment outcomes (n = 3). Only minimal changes in synergies were found after treatment. Conclusions: The findings in this systematic review support the idea that children with CP use a simpler motor control strategy compared to TD children. The use of muscle synergy analysis as a clinical tool to quantify altered neuromuscular control and predict clinical outcomes seems promising. Further investigation on this topic is necessary, and the use of muscle synergies as a target for development of novel therapies in children with CP could be explored.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Muscle Synergies During Walking in Children With Cerebral Palsy: A Systematic Review

et al. 2020

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Muscle synergy analysis in children with cerebral palsy

et al. 2015

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Assessment of Upper Limb Motor Dysfunction for Children with Cerebral Palsy Based on Muscle Synergy Analysis

Tang

Chen

Cao

et al. 2017

Front. Hum. Neurosci.

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Muscle synergies are considered to be building blocks underlying motor behaviors. The goal of this study is to explore an objective and effective method to assess the upper limb motor dysfunction of cerebral palsy (CP) children from the aspect of muscle synergy analysis. Fourteen CP children and 10 typically developed (TD) children were recruited to perform three similar upper limb motion tasks related to the movements of elbow and shoulder joints, and surface electromyographic (sEMG) signals were recorded from 10 upper arm and shoulder muscles involved in the defined tasks. Non-negative matrix factorization algorithm was used to extract muscle synergies and the corresponding activation patterns during three similar tasks. For each subject in TD group, four muscle synergies were extracted in each task. Whereas, fewer mature synergies were recruited in CP group, and many abnormal synergy structures specific to CP group appeared. In view of neuromuscular control strategy differences, three synergy-related parameters were proposed and synergy structure similarity coefficient was found to have high ability in depicting the inter-subject similarity within task and the intra-subject similarity between tasks. Seven upper limb assessment (UPA) metrics, which were defined as the combinations of synergy structure similarity coefficients of three tasks, were proposed to assess the upper limb motor function of CP children. The experimental results demonstrated that these UPA metrics were able to assess upper limb motor function comprehensively and effectively. The proposed assessment method can serve as a promising approach to quantify the abnormality of muscle synergies, thus offering potential to derive a physiologically based quantitative index for assessing upper limb motor function in CP clinical diagnosis and rehabilitation.

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Modular Control of Crouch Gait in Spastic Cerebral Palsy

Cited by 5 publications

References 4 publications

Muscle Synergies During Walking in Children With Cerebral Palsy: A Systematic Review

Muscle Synergies During Walking in Children With Cerebral Palsy: A Systematic Review

Muscle synergy analysis in children with cerebral palsy

Assessment of Upper Limb Motor Dysfunction for Children with Cerebral Palsy Based on Muscle Synergy Analysis

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