Neuromuscular Control before and after Independent Walking Onset in Children with Cerebral Palsy
Annike Bekius,
Coen S. Zandvoort,
Jennifer N. Kerkman,
Laura A. van de Pol,
R. Jeroen Vermeulen,
Jaap Harlaar,
Andreas Daffertshofer,
Annemieke I. Buizer,
Nadia Dominici
Affiliations
Annike Bekius
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
Coen S. Zandvoort
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
Jennifer N. Kerkman
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
Laura A. van de Pol
Department of Pediatric Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
R. Jeroen Vermeulen
Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
Jaap Harlaar
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
Andreas Daffertshofer
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
Annemieke I. Buizer
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
Nadia Dominici
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
Early brain lesions which produce cerebral palsy (CP) may affect the development of walking. It is unclear whether or how neuromuscular control, as evaluated by muscle synergy analysis, differs in young children with CP compared to typically developing (TD) children with the same walking ability, before and after the onset of independent walking. Here we grouped twenty children with (high risk of) CP and twenty TD children (age 6.5–52.4 months) based on their walking ability, supported or independent walking. Muscle synergies were extracted from electromyography data of bilateral leg muscles using non-negative matrix factorization. Number, synergies’ structure and variability accounted for when extracting one (VAF1) or two (VAF2) synergies were compared between CP and TD. Children in the CP group recruited fewer synergies with higher VAF1 and VAF2 compared to TD children in the supported and independent walking group. The most affected side in children with asymmetric CP walking independently recruited fewer synergies with higher VAF1 compared to the least affected side. Our findings suggest that early brain lesions result in early alterations of neuromuscular control, specific for the most affected side in asymmetric CP.
