TY - JOUR
T1 - The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy
AU - Ettema, Sanne
AU - Oudenhoven, Laura M.
AU - Roeleveld, Karin
AU - Buizer, Annemieke I.
AU - van der Krogt, Marjolein M.
N1 - Funding Information:
This work was supported by HandicapNL , Grant no: #R201605435 , Phelps Stichting voor Spastici Grant no: #2017.015 , JKF Kinderfonds Grant no.: #20170006 , Cornelia-Stichting Grant no.: #R201605435 and Kinderrevalidatie Fonds Adriaanstichting as part of the MOVING-CP project. SE was also supported by a Gerrit-Jan van Ingen-Schenau promising young scientist award 2019–2020 and the Amsterdam Movement Sciences Talent call 2020.
Publisher Copyright:
© 2022
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: Muscle fatigue of the lower limbs is considered a main contributor to the perceived fatigue in children with cerebral palsy (CP) and is expected to occur during prolonged walking. In adults without disabilities, muscle fatigue has been proposed to be associated with adaptations in complexity of neuromuscular control. Research question: What are the effects of prolonged walking on signs of muscle fatigue and complexity of neuromuscular control in children with CP? Methods: Ten children with CP and fifteen typically developing (TD) children performed a standardised protocol on an instrumented treadmill consisting of three stages: six-minutes walking at preferred speed (6 MW), moderate-intensity walking (MIW, with two minutes at heart rate > 70% of predicted maximal heart rate) and four-minutes walking at preferred speed (post-MIW). Electromyography (EMG) data were analysed for eight muscles of one leg during three time periods: 6 MW-start, 6 MW-end and post-MIW. Signs of muscle fatigue were quantified as changes in EMG median frequency and EMG root mean square (RMS). Complexity of neuromuscular control was quantified by total variance accounted for by one synergy (tVAF1). Muscle coactivation was assessed for antagonistic muscle pairs. Results: EMG median frequency was decreased at 6 MW-end and post-MIW compared to 6 MW-start in children with CP (p < 0.05), but not in TD children. In both groups, EMG-RMS (p < 0.01) and muscle coactivation (p < 0.01) were decreased at 6 MW-end and post-MIW compared to 6 MW-start. tVAF1 decreased slightly at 6 MW-end and post-MIW compared to 6 MW-start in both groups (p < 0.05). Changes were most pronounced from 6 MW-start to 6 MW-end. Significance: Children with CP presented signs of muscle fatigue after prolonged walking, while no effects were found for TD. Both groups showed minimal changes in tVAF1, suggesting signs of muscle fatigue are not associated with changes in complexity of neuromuscular control.
AB - Background: Muscle fatigue of the lower limbs is considered a main contributor to the perceived fatigue in children with cerebral palsy (CP) and is expected to occur during prolonged walking. In adults without disabilities, muscle fatigue has been proposed to be associated with adaptations in complexity of neuromuscular control. Research question: What are the effects of prolonged walking on signs of muscle fatigue and complexity of neuromuscular control in children with CP? Methods: Ten children with CP and fifteen typically developing (TD) children performed a standardised protocol on an instrumented treadmill consisting of three stages: six-minutes walking at preferred speed (6 MW), moderate-intensity walking (MIW, with two minutes at heart rate > 70% of predicted maximal heart rate) and four-minutes walking at preferred speed (post-MIW). Electromyography (EMG) data were analysed for eight muscles of one leg during three time periods: 6 MW-start, 6 MW-end and post-MIW. Signs of muscle fatigue were quantified as changes in EMG median frequency and EMG root mean square (RMS). Complexity of neuromuscular control was quantified by total variance accounted for by one synergy (tVAF1). Muscle coactivation was assessed for antagonistic muscle pairs. Results: EMG median frequency was decreased at 6 MW-end and post-MIW compared to 6 MW-start in children with CP (p < 0.05), but not in TD children. In both groups, EMG-RMS (p < 0.01) and muscle coactivation (p < 0.01) were decreased at 6 MW-end and post-MIW compared to 6 MW-start. tVAF1 decreased slightly at 6 MW-end and post-MIW compared to 6 MW-start in both groups (p < 0.05). Changes were most pronounced from 6 MW-start to 6 MW-end. Significance: Children with CP presented signs of muscle fatigue after prolonged walking, while no effects were found for TD. Both groups showed minimal changes in tVAF1, suggesting signs of muscle fatigue are not associated with changes in complexity of neuromuscular control.
KW - Biomechanics
KW - Clinical gait analysis
KW - Electromyography
KW - Muscle synergies
KW - Rehabilitation
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85122748448&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35042058
U2 - 10.1016/j.gaitpost.2022.01.004
DO - 10.1016/j.gaitpost.2022.01.004
M3 - Article
C2 - 35042058
SN - 0966-6362
VL - 93
SP - 7
EP - 13
JO - Gait and Posture
JF - Gait and Posture
ER -