EMG-Based Characterization of Walking Asymmetry in Children with Mild Hemiplegic Cerebral Palsy

Biosensors (Basel). 2019 Jun 27;9(3):82. doi: 10.3390/bios9030082.

Abstract

Hemiplegia is a neurological disorder that is often detected in children with cerebral palsy. Although many studies have investigated muscular activity in hemiplegic legs, few EMG-based findings focused on unaffected limb. This study aimed to quantify the asymmetric behavior of lower-limb-muscle recruitment during walking in mild-hemiplegic children from surface-EMG and foot-floor contact features. sEMG signals from tibialis anterior (TA) and gastrocnemius lateralis and foot-floor contact data during walking were analyzed in 16 hemiplegic children classified as W1 according to Winter' scale, and in 100 control children. Statistical gait analysis, a methodology achieving a statistical characterization of gait by averaging surface-EMG-based features, was performed. Results, achieved in hundreds of strides for each child, indicated that in the hemiplegic side with respect to the non-hemiplegic side, W1 children showed a statistically significant: decreased number of strides with normal foot-floor contact; decreased stance-phase length and initial-contact sub-phase; curtailed, less frequent TA activity in terminal swing and a lack of TA activity at heel-strike. The acknowledged impairment of anti-phase eccentric control of dorsiflexors was confirmed in the hemiplegic side, but not in the contralateral side. However, a modified foot-floor contact pattern is evinced also in the contralateral side, probably to make up for balance requirements.

Keywords: cerebral palsy; children locomotion; gait; hemiplegia; motor disorders; surface electromyography.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Cerebral Palsy / diagnosis*
  • Cerebral Palsy / physiopathology*
  • Child
  • Child, Preschool
  • Electromyography* / methods
  • Female
  • Gait*
  • Hemiplegia / diagnosis*
  • Hemiplegia / physiopathology*
  • Humans
  • Male
  • Muscle, Skeletal / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Symptom Assessment
  • Walking*