Department of Rehabilitation Medicine, Research institute MOVE, VU University Medical Center, De Boelelaan 1117, 1088 HV Amsterdam, The Netherlands.
Gait Posture. 2012 Jan;35(1):111-5. doi: 10.1016/j.gaitpost.2011.08.019. Epub 2011 Sep 15.
Selective motor control (SMC) is an important determinant of functioning in cerebral palsy (CP). Currently its assessment is based on subjective clinical tests with a low sensitivity. Electromyography (EMG) profiles during gait represent muscle coordination and might be used to assess SMC. EMG measurements during gait were processed into a measure of extensor synergy and thigh synergy. This was obtained in two groups of children with CP, and 30 typically developing children. Extensor synergy in CP was higher (0.95) than in healthy children (0.77), thigh synergy was almost equal in both groups. GMFM scores in the first group of 39 children with CP did not correlate to EMG based synergy measures. In a second group of 38 children with CP, a clear relation of clinical SMC score with extensor synergy was found, but only a weak relation with thigh synergy. Although an extensor synergy was validated at group level, our results present no convincing evidence for the use of EMG during gait to assess SMC in individual subjects with CP. Since gait involves both synergistic and selective contractions, the inherent motor control properties of this task will not allow for an assessment of selectivity comparable to the ability to perform isolated movements. Nevertheless, our results support the sensitive nature of EMG to represent an aberrant motor control in CP.
选择性运动控制（SMC）是脑瘫（CP）功能的重要决定因素。目前，其评估基于低灵敏度的主观临床测试。步态中的肌电图（EMG）图谱代表肌肉协调，可用于评估 SMC。对步态中的 EMG 测量值进行处理，得出伸肌协同性和大腿协同性的度量。将其应用于两组 CP 儿童和 30 名正常发育儿童中。CP 中的伸肌协同性（0.95）高于健康儿童（0.77），两组之间的大腿协同性几乎相等。第一组 39 名 CP 儿童的 GMFM 评分与基于 EMG 的协同度量值不相关。在第二组 38 名 CP 儿童中，发现临床 SMC 评分与伸肌协同性之间存在明确关系，但与大腿协同性之间仅存在弱关系。尽管在组水平上验证了伸肌协同性，但我们的结果没有为使用步态中的 EMG 评估 CP 个体中的 SMC 提供令人信服的证据。由于步态涉及协同性和选择性收缩，因此该任务的固有运动控制特性将不允许对选择性进行与执行孤立运动的能力相当的评估。然而，我们的结果支持 EMG 能够敏感地代表 CP 中的异常运动控制。
