Abstract
Background Poor control of postural muscles is a primary impairment in people with cerebral palsy (CP).
Objective The purpose of this study was to investigate differences in the timing characteristics of trunk and hip muscle activity during walking in young children with CP compared with children with typical development (TD).
Methods Thirty-one children (16 with TD, 15 with CP) with an average of 28.5 months of walking experience participated in this observational study. Electromyographic data were collected from 16 trunk and hip muscles as participants walked at a self-selected pace. A custom-written computer program determined onset and offset of activity. Activation and coactivation data were analyzed for group differences.
Results The children with CP had greater total activation and coactivation for all muscles except the external oblique muscle and differences in the timing of activation for all muscles compared with the TD group. The implications of the observed muscle activation patterns are discussed in reference to existing postural control literature.
Limitations The potential influence of recording activity from adjacent deep trunk muscles is discussed, as well as the influence of the use of an assistive device by some children with CP.
Conclusions Young children with CP demonstrate excessive, nonreciprocal trunk and hip muscle activation during walking compared with children with TD. Future studies should investigate the efficacy of treatments to reduce excessive muscle activity and improve coordination of postural muscles in CP.
Footnotes
-
All authors provided concept/idea/research design and reviewed the manuscript prior to submission. Dr Prosser, Dr Lee, Dr VanSant, and Dr Lauer provided writing and facilities/equipment. Dr Prosser provided data collection, project management, and participants. Dr Prosser, Dr Lee, and Dr Lauer provided data analysis and fund procurement.
-
The authors thank Steve Capella and Jenny Lee for their assistance with data collection and Diana Deshefy, PT, DPT, Samuel Pierce, PT, PhD, and Erin Sheeder, PT, DPT, for assistance with participant recruitment.
-
Preliminary results of this study were included in a poster presentation at the Combined Sections Meeting of the American Physical Therapy Association; February 9–12, 2009; Las Vegas, Nevada.
-
The Institutional Review Board of Temple University Hospital (for Shriners Hospital) and the institutional review boards of the additional data collection sites approved all procedures.
-
Direct costs for this study, incuding data acquisition equipment, supplies, travel to data collection sites, and consultant fees, were funded by a Clinical Research Grant to Dr Prosser from the Section on Pediatrics, American Physical Therapy Association. A National Institute of Neurological Disorders and Stroke grant (R03NS048875) to Dr Lauer funded the time of the principal investigator and a coinvestigator and costs related to dissemination. A National Institute of Child Health and Human Development grant (R01HD043859) to Dr Lee funded the time of a coinvestigator and research aides. This research also was supported, in part, by the Intramural Research Program of the Clinical Center, National Institutes of Health.
- Received May 15, 2009.
- Accepted March 22, 2010.
- © 2010 American Physical Therapy Association
Issue highlights
