Kim Yushin, Bulea Thomas C, Damiano Diane L
Major of Sports Health Rehabilitation, Cheongju University, Cheongju, South Korea.
Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, United States.
Front Physiol. 2021 Feb 23;12:630627. doi: 10.3389/fphys.2021.630627. eCollection 2021.
Children with cerebral palsy typically exhibit reduced complexity of muscle coordination patterns during walking; however, the specific patterns that characterize their gait abnormalities are still not well documented. This study aimed to identify the specific repertoire of muscle coordination patterns in children with CP during walking compared to same-aged peers without CP and their relationships to gait performance. To identify muscle coordination patterns, we extracted muscle synergies from 10 children with CP and 10 age-matched typically developing children (TD). K-mean clustering and discriminant analyses of all extracted synergies were used to group similar synergies. Then, weight-averaged z-scores were quantified for each cluster to determine their group-specific level. In this cohort, 10 of the 17 distinct clusters were largely CP-specific while six clusters were seen mainly in TD, and one was non-specific. CP-specific clusters generally showed merging of two TD synergies, excessive antagonist co-activation, decreased muscle activation compared to TD, and complex or atypical pattern. Significant correlations were found between weight-averaged z-scores and step length asymmetry, cadence asymmetry, self-selected treadmill speed and AP-COM displacement of the pelvis such that greater CP-specificity of muscle synergies was related to poorer performance, thus indicating that CP-specific synergies can influence motor dysfunction.
患有脑瘫的儿童在行走过程中通常表现出肌肉协调模式的复杂性降低；然而，表征其步态异常的具体模式仍未得到充分记录。本研究旨在确定与同龄无脑瘫儿童相比，脑瘫儿童在行走过程中肌肉协调模式的具体组成，以及这些模式与步态表现的关系。为了确定肌肉协调模式，我们从10名脑瘫儿童和10名年龄匹配的正常发育儿童（TD）中提取了肌肉协同作用。对所有提取的协同作用进行K均值聚类和判别分析，以对相似的协同作用进行分组。然后，对每个聚类量化加权平均z分数，以确定其特定组水平。在该队列中，17个不同聚类中的10个主要是脑瘫特异性的，6个聚类主要出现在正常发育儿童中，1个是非特异性的。脑瘫特异性聚类通常表现为两个正常发育儿童协同作用的合并、过度的拮抗肌共同激活、与正常发育儿童相比肌肉激活减少，以及复杂或非典型模式。在加权平均z分数与步长不对称、步频不对称、自行选择的跑步机速度和骨盆前后-中心位移之间发现了显著相关性，因此肌肉协同作用的脑瘫特异性越高，与表现越差相关，这表明脑瘫特异性协同作用可影响运动功能障碍。
