EMG-Based Characterization of Walking Asymmetry in Children with Mild Hemiplegic Cerebral Palsy

• Published in: Biosensors (Basel) Vol. 9; no. 3; p. 82
• Main Authors: Di Nardo, Francesco, Strazza, Annachiara, Mengarelli, Alessandro, Cardarelli, Stefano, Tigrini, Andrea, Verdini, Federica, Nascimbeni, Alberto, Agostini, Valentina, Knaflitz, Marco, Fioretti, Sandro
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.06.2019; MDPI
• Subjects: Adolescent; Ankle; Asymmetry; Bone surgery; Case-Control Studies; Cerebral palsy; Cerebral Palsy - diagnosis; Cerebral Palsy - physiopathology; Child; Child, Preschool; Children; Children & youth; children locomotion; Electromyography; Electromyography - methods; Feet; Female; Floors; Gait; Heels; Hemiplegia; Hemiplegia - diagnosis; Hemiplegia - physiopathology; Hemispheric laterality; Humans; Laboratories; Male; motor disorders; Muscle, Skeletal - physiopathology; Muscles; Neurological diseases; Paralysis; Recruitment; Retrospective Studies; Severity of Illness Index; Signal processing; Signal to noise ratio; Statistical analysis; Statistics; surface electromyography; Symptom Assessment; Walking; Italy; children locomotion; cerebral palsy; hemiplegia; surface electromyography; motor disorders; gait
• ISSN: 2079-6374; 2079-6374
• DOI: 10.3390/bios9030082

Hemiplegia is a neurological disorder that is often detected in children with cerebral palsy. Although many studies have investigated muscular activity in hemiplegic legs, few EMG-based findings focused on unaffected limb. This study aimed to quantify the asymmetric behavior of lower-limb-muscle recruitment during walking in mild-hemiplegic children from surface-EMG and foot-floor contact features. sEMG signals from tibialis anterior (TA) and gastrocnemius lateralis and foot-floor contact data during walking were analyzed in 16 hemiplegic children classified as W1 according to Winter’ scale, and in 100 control children. Statistical gait analysis, a methodology achieving a statistical characterization of gait by averaging surface-EMG-based features, was performed. Results, achieved in hundreds of strides for each child, indicated that in the hemiplegic side with respect to the non-hemiplegic side, W1 children showed a statistically significant: decreased number of strides with normal foot-floor contact; decreased stance-phase length and initial-contact sub-phase; curtailed, less frequent TA activity in terminal swing and a lack of TA activity at heel-strike. The acknowledged impairment of anti-phase eccentric control of dorsiflexors was confirmed in the hemiplegic side, but not in the contralateral side. However, a modified foot-floor contact pattern is evinced also in the contralateral side, probably to make up for balance requirements.