Synergies CP Lokomat
Pediatric Cerebral Palsy (CP) is one of the most common causes of disability in children. It is a group of disorders affecting movement, development, and posture that causes functional limitation in children. Characteristics of CP include weakness, spasticity, and the loss of selective motor control. Some studies have shown that the sensitive nature of EMG to represent an aberrant motor control in CP and children with CP utilized fewer synergies during gait than in typically developing children and the complexity of control, as measured by synergies, was reduced during gait in individuals with CP compared with unimpaired individuals, and was related to functional ability and clinical examination measures. Training interventions have been used and have demonstrated some beneficial effects of intensive task-specific gait training on motor recovery in children with CP.
In this study we are using a technique referred to as “muscle synergies”, which is designed to analyze the activity of muscles. We believe that studying muscle synergies would allow us to capture the severity of impairments in selective motor control (SMC) in a way that is more mechanistic than traditional clinical scales to assess SMC. We also hypothesize that abnormalities in muscle synergies would account for better responsiveness to robot-assisted gait training better than traditional clinical measures of SMC. If the hypothesis is true, the approach which the lab is taking, would allow us to design patient-specific rehabilitation interventions that would target abnormalities in muscle synergies that could be used prior to the administration of robot-assisted gait training, as a way to re-enable motor learning strategies that would allow children with CP to fully benefit from robot-assisted gait training. If feasible, the proposed approach would be expected to significantly improve clinical outcomes of robot-assisted gait training in children with CP.
The study will consist of a total of 18 testing sessions and 2 evaluations before and after the study has been conducted. We ask that you would come three times a week, for six weeks. Each session will last approximately one hour and will take place at the Motion Analysis Lab at Spaulding Rehabilitation Hospital. All individuals must undergo an initial phone screen, must meet all inclusion criteria and must undergo a final in-person screen to determine eligibility.
- · Diagnosis of spastic Cerebral Palsy
- · Must be between 6-18 years old
- · Gross Motor Function Level: I, II, or III
- · Body/femoral length < size of Lokomat robotic arm (femur length between 210-350 mm)
- · Ability to communicate any pain or discomfort
- · Recent use of Lokomat within the last 3 months.
- · Contraindication to robotic-assisted gait training such as thromboembolic disease, progressive neurologic disorder, cardiovascular or pulmonary contraindications, aggressive behaviors, severe cognitive deficits, bone instabilities, fractures, or osteoporosis
- · Skin ulcers in trunk or lower limbs
- · Hip, knee, ankle arthrodesis.
If you are interested in this study and would like to participate or learn more, please contact the Motion Analysis Volunteer line at 617-952-6331. Please do not hesitate to call with any questions or concerns, which you may have.