Muscle synergy structure and gait patterns in children with spastic cerebral palsy

Marije Goudriaan; Eirini Papageorgiou; Benjamin R. Shuman; Katherine M. Steele; Nadia Dominici; Anja Van Campenhout; Els Ortibus; Guy Molenaers; Kaat Desloovere

doi:10.1111/dmcn.15068

Muscle synergy structure and gait patterns in children with spastic cerebral palsy

Marije Goudriaan
, Eirini Papageorgiou
, Benjamin R. Shuman
, Katherine M. Steele
, Nadia Dominici
, Anja Van Campenhout
, Els Ortibus
, Guy Molenaers
, Kaat Desloovere

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Aim
To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP).

Method
In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo–17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization. We compared synergy activations and weights between the patterns.

Results
Synergy structure was similar between gait patterns, although weights differed in the more impaired children (crouch and jump gait) when compared to the other patterns. Variability in synergy structure between participants was high.

Interpretation
The similarity in synergy structure between gait patterns suggests a generic motor control strategy to compensate for the brain lesion. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level.

Abstract
This original article is commented by D'Avella et al. on pages 404–405 of this issue.

Original language	English
Pages (from-to)	462-468
Number of pages	7
Journal	Developmental Medicine and Child Neurology
Volume	64
Issue number	4
Early online date	6 Oct 2021
DOIs	https://doi.org/10.1111/dmcn.15068
Publication status	Published - Apr 2022

Funding

We thank the staff of the clinical motion analysis laboratory of Pellenberg for the data collection of the 3D gait analyses. MG and ND were funded by the Dutch Organization for Scientific Research VIDI grant (no. 016.156.346 FirSTeps), the European Research Council 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. EP was supported by the SIMCP IWT‐project (Agentschap voor Innovatie door Wetenschap en Technologie), a simulation platform to predict gait performance after orthopedic intervention in children with CP (IWT 140184), the Flemish Research Council (grant number T003116N), and the KU Leuven Internal Funds C24M/19/064. KS and BS were supported by the National Institutes of Health (grant number R01NS091056).

Funders	Funder number
European Research Council
Agentschap voor Innovatie door Wetenschap en Technologie	IWT 140184
Johanna Kinderfonds and Kinderrevalidatie Fonds Adriaanstichting	20200028
KU Leuven	C24M/19/064
Flemish Research Council	T003116N
Dutch Organization for Scientific Research VIDI	016.156.346 FirSTeps
National Institutes of Health	R01NS091056
Horizon 2020 Framework Programme	715945

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title = "Muscle synergy structure and gait patterns in children with spastic cerebral palsy",

abstract = "Aim To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP). Method In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo–17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization. We compared synergy activations and weights between the patterns. Results Synergy structure was similar between gait patterns, although weights differed in the more impaired children (crouch and jump gait) when compared to the other patterns. Variability in synergy structure between participants was high. Interpretation The similarity in synergy structure between gait patterns suggests a generic motor control strategy to compensate for the brain lesion. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level. Abstract This original article is commented by D'Avella et al. on pages 404–405 of this issue. ",

author = "Marije Goudriaan and Eirini Papageorgiou and Shuman, \{Benjamin R.\} and Steele, \{Katherine M.\} and Nadia Dominici and \{Van Campenhout\}, Anja and Els Ortibus and Guy Molenaers and Kaat Desloovere",

year = "2022",

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doi = "10.1111/dmcn.15068",

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T1 - Muscle synergy structure and gait patterns in children with spastic cerebral palsy

AU - Goudriaan, Marije

AU - Papageorgiou, Eirini

AU - Shuman, Benjamin R.

AU - Steele, Katherine M.

AU - Dominici, Nadia

AU - Van Campenhout, Anja

AU - Ortibus, Els

AU - Molenaers, Guy

AU - Desloovere, Kaat

PY - 2022/4

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N2 - Aim To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP). Method In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo–17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization. We compared synergy activations and weights between the patterns. Results Synergy structure was similar between gait patterns, although weights differed in the more impaired children (crouch and jump gait) when compared to the other patterns. Variability in synergy structure between participants was high. Interpretation The similarity in synergy structure between gait patterns suggests a generic motor control strategy to compensate for the brain lesion. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level. Abstract This original article is commented by D'Avella et al. on pages 404–405 of this issue.

AB - Aim To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP). Method In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo–17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization. We compared synergy activations and weights between the patterns. Results Synergy structure was similar between gait patterns, although weights differed in the more impaired children (crouch and jump gait) when compared to the other patterns. Variability in synergy structure between participants was high. Interpretation The similarity in synergy structure between gait patterns suggests a generic motor control strategy to compensate for the brain lesion. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level. Abstract This original article is commented by D'Avella et al. on pages 404–405 of this issue.

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Muscle synergy structure and gait patterns in children with spastic cerebral palsy

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