A longitudinal analysis of selective motor control during gait in individuals with cerebral palsy and the relation to gait deviations

PLoS One. 2023 Jul 31;18(7):e0289124. doi: 10.1371/journal.pone.0289124. eCollection 2023.

Abstract

Objective: To investigate longitudinal changes in selective motor control during gait (SMCg) in individuals with cerebral palsy (CP), and to assess if they are related to changes in gait deviations.

Method: Twenty-three children/adolescents with spastic CP (mean ± SD age = 9.0±2.5 years) and two 3D gait assessments (separated by 590±202 days) with no interim surgical intervention, were included. SMCg was assessed using muscle synergy analysis to determine the dynamic motor control index (walk-DMC). Gait deviation was assessed using the Gait profile score (GPS) and Gait variable scores (GVS).

Results: There were no mean changes in walk-DMC score, GPS or GVS between assessments. However, changes in walk-DMC scores in the more involved leg related to changes in hip flexion-extension and hip internal-external GVS (rp = -0.56; p = 0.017 and rp = 0.65; p = 0.004, respectively).

Conclusions: On average, there were no significant longitudinal changes in SMCg. However, there was considerable variability between individuals, which may relate to changes in hip joint kinematics. This suggests that a combination of neural capacity and biomechanical factors influence lower limb muscle co-activation in individuals with CP, with a potential important role for the hip muscles. These findings highlight the importance of taking an individualized approach when evaluating SMCg in individuals with CP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomechanical Phenomena
  • Cerebral Palsy*
  • Child
  • Gait / physiology
  • Humans
  • Lower Extremity
  • Muscle, Skeletal
  • Walking

Grants and funding

SHS is a principal investigator and GS is a research fellow, both funded by The Leona M. & Henry B. Helmsley Charitable Trust (no. 2207-05386). SHS also received internal funding from ALYN hospital supported by the Centre for Integration in Science at the Ministry of Absorption and integration. MG was funded by the Dutch Organization for Scientific Research (NWO) VIDI grant (no. 016.156.346 FirSTeps), the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (no. 715945 Learn2Walk), the Johanna Kinderfonds and Kinderrevalidatie Fonds Adriaanstichting (no.20200028), and internal funding of the Vrije Universiteit Amsterdam, the Netherlands. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.