Dynamic electromyography findings of the lower leg muscles during walking in spastic cerebral palsy children with hindfoot valgus

Xuesen Wang; Xiaohu Fu; Wei Li; Qining Wang; Kuan Zhang; Songhua Yan

doi:10.1016/j.clinbiomech.2023.106008

Dynamic electromyography findings of the lower leg muscles during walking in spastic cerebral palsy children with hindfoot valgus

Clin Biomech (Bristol, Avon). 2023 Jun:106:106008. doi: 10.1016/j.clinbiomech.2023.106008. Epub 2023 May 20.

Authors

Xuesen Wang¹, Xiaohu Fu², Wei Li³, Qining Wang⁴, Kuan Zhang⁵, Songhua Yan⁶

Affiliations

¹ School of Biomedical Engineering, Capital Medical University, Beijing, China; Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
² Rehabilitation Department of Beijing Children's Hospital, Capital Medical University, Beijing, China.
³ Department of Rehabilitation, Affiliated Hospital of Binzhou Medical College, Shandong, China.
⁴ Robotics Research Group, College of Engineering, Peking University, Beijing, China.
⁵ School of Biomedical Engineering, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical application, Capital Medical University, Beijing, China. Electronic address: kzhang@ccmu.edu.cn.
⁶ School of Biomedical Engineering, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical application, Capital Medical University, Beijing, China. Electronic address: yansh74@ccmu.edu.cn.

PMID: 37257273
DOI: 10.1016/j.clinbiomech.2023.106008

Abstract

Background: Hindfoot valgus is one of the most prevalent foot deformities in cerebral palsy children. Investigating the muscle activation patterns of cerebral palsy children with hindfoot valgus is crucial to understand their abnormal gait different from typically developing children.

Methods: Electromyography data of 20 cerebral palsy children with hindfoot valgus and 20 typically developing children were recorded for tibialis anterior, peroneal longus, and gastrocnemius medialis. The activation onset and offset times, normalized peak electromyography amplitude, average electromyography amplitude and integral electromyography amplitude for 20 completed cycles were averaged for data analysis. The co-activation index and activation percentage of peroneal longus were used to evaluate the co-activation level for tibialis anterior and peroneal longus muscles.

Findings: Compared with typically developing children, the activation onset of tibialis anterior and the activation offset of tibialis anterior, peroneal longus, and gastrocnemius medialis were significantly delayed in cerebral palsy children; moreover, the muscle activation durations of tibialis anterior, peroneal longus, and gastrocnemius medialis were significantly longer, and the normalized average electromyography amplitude of tibialis anterior, peroneal longus and gastrocnemius medialis, and the normalized integral electromyography amplitude of tibialis anterior were significantly lower in cerebral palsy children. Furthermore, for cerebral palsy children, the co-activation index was greater, and the peroneal longus muscles activation percentage was lower in the stance phase and greater in the swing phase than that of typically developing children.

Interpretation: The lower leg muscle activation patterns in cerebral palsy children were found to be abnormal.

Keywords: 20 gait cycles; Dynamic electromyography; Gait analysis; Hindfoot valgus; Spastic cerebral palsy; The lower leg muscles.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cerebral Palsy* / complications
Child
Electromyography
Gait / physiology
Humans
Leg*
Muscle Spasticity
Muscle, Skeletal / physiology
Walking / physiology