Associations between muscle synergies and treatment outcomes in cerebral palsy are robust across clinical centers

Publication date: Available online 10 April 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Benjamin R. Shuman, Marije Goudriaan, Kaat Desloovere, Michael H. Schwartz, Katherine M. Steele
ObjectiveTo determine whether patient-specific differences in motor control quantified using muscle synergy analysis were associated with changes in gait after treatment in cerebral palsy across two clinical centers with different treatments and clinical protocols.DesignRetrospective Cohort Study.SettingClinical Medical Center.ParticipantsCenter 1: 473 children with cerebral palsy and 84 typically-developing children. Center 2: 163 children with cerebral palsy and 12 typically-developing children.InterventionsStandard clinical care at each center.Outcome MeasuresThe dynamic motor control index during walking (walk-DMC) was computed from electromyography data during gait using muscle synergy analysis. Regression analysis was used to evaluate whether pre-treatment walking speed or kinematics, muscle synergies, treatment group, prior treatment, or age were associated with post-treatment changes in gait at both clinical centers.ResultsWalk-DMC was significantly associated with changes in speed and kinematics after treatment with similar regression models at both centers. Children with less impaired motor control were more likely to have improvements in walking speed and gait kinematics after treatment, independent of treatment group.ConclusionsDynamic motor control evaluated with synergy analysis was associated with changes in gait after treatment at both centers, despite differences in treatments and clinical protocols. This study further supports the finding that walk-DMC provides additional information, not captured in traditional gait analysis, that may be useful for treatment planning.



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