Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bldg 10-CRC, 1-1469 10 Center Dr, Bethesda, MD 20892, USA.
Phys Ther. 2010 Jul;90(7):986-97. doi: 10.2522/ptj.20090161. Epub 2010 Apr 29.
Poor control of postural muscles is a primary impairment in people with cerebral palsy (CP).
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).
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.
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.
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.
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.
姿势肌肉控制不良是脑瘫（CP）患者的主要障碍。
本研究旨在探讨与发育正常（TD）儿童相比，CP 儿童在行走时躯干和髋部肌肉活动的时间特征差异。
31 名儿童（16 名 TD，15 名 CP）平均有 28.5 个月的行走经验参与了这项观察性研究。参与者以自选择的速度行走时，从 16 个躯干和髋部肌肉中收集肌电图数据。一个自定义编写的计算机程序确定活动的开始和结束。对组间差异进行了激活和共激活数据分析。
与 TD 组相比，CP 组的所有肌肉的总激活和共激活都更大，除了腹外斜肌，所有肌肉的激活时间也存在差异。观察到的肌肉激活模式的影响在参考现有的姿势控制文献时进行了讨论。
讨论了记录相邻深躯干肌肉活动的潜在影响，以及一些 CP 儿童使用辅助设备的影响。
与 TD 儿童相比，CP 儿童在行走时表现出过度的、非交互的躯干和髋部肌肉激活。未来的研究应调查治疗方法的效果，以减少 CP 中的过度肌肉活动并改善姿势肌肉的协调性。
