Comparison of Frequency Spectrum of Ground Reaction Forces and Electromyography ‎Activities in Cerebral Palsy with Healthy Children During Walking

Document Type : Original Article

Authors

1 Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

2 Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, Islamic Azad University, Yasouj, Iran

3 Department of Physical Education and Sport Sciences, Tabriz Islamic Azad University, Tabriz, Iran

Abstract

Purpose:
The aim of this study was to compare the frequency of ground reaction forces and electromyography activities in healthy children with cerebral palsy while walking.
Methods:
This study was quasi-experimental. Study population included 12 boys with cerebral palsy and 12 healthy boys with age range of 6-10 years. The force plate (Kistler) was used to record ground reaction forces during walking. A wireless electromyography system with 8 pairs of dipole surface electrodes was also used to record Electromyography activity of selected lower limb muscles during walking.
Results:
The results showed that the frequency with 99.5% power (P=0.004) and number of anterior-posterior essential harmonics of the cerebral palsy group compared to the healthy group were 41.58% and 32.83% higher, respectively. The frequency with 99.5% power in ertical direction was 40.94% higher in cerebral palsy group compared to healthy group (P = 0.004). Frequency with 99.5% power in the component of free torque in cerebral palsy group was 27.57% more than control group. Mean frequency of anterior tibialis muscle, internal gastrocnemius, biceps femoris and medial serine in the cerebral palsy group compared with the healthy group were 31.67%, 19.63%, 21.96% and 26.70% lower, respectively.
Conclusion:
The results showed that the median frequency of lower limb muscles was lower in children with cerebral palsy than in healthy children. It can be stated that the frequency spectrum content of ground reaction forces and electromyography activities is of clinical value. Therefore, the application of therapeutic interventions to improve the frequency spectrum indices of ground reaction forces and electromyography activities in children with cerebral palsy is suggested.

Keywords


  1. Webb W, Adler RK. Neurology for the Speech-Language Pathologist-E-Book: Elsevier health sciences; 2016: 251-265.
  2. Jalili N, Godarzi M, Rassafiani M, Haghgou H, et al. The influenced factors on quality of life of mothers of children with severe cerebral palsy: A survey study, Journal of Modern Rehabilitation 2013; 3(7): 40-47.  [Persian]
  3. Dalvand H, Dehghan L, Hadian MR, Feizy A, Hosseini SA. Relationship between gross motor and intellectual function in children with cerebral palsy: a cross-sectional study. ACRM 2012; 93(3): 480-484.  [Persian]
  4. Dobkin BH, Duncan PW. Should body weight–supported treadmill training and robotic-assistive steppers for locomotor training trot back to the starting gate? NNR 2012; 26(4): 308-317.
  5. Damiano DL, DeJong SL. A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation. Journal of neurologic physical therapy: JNPT 2009; 33(1): 27.
  6. Drużbicki M, Rusek W, Szczepanik M, Dudek J, SNELA S. Assessment of the impact of orthotic gait training on balance in children with cerebral palsy. Acta Bioeng Biomech 2010; 12(3): 53-58.
  7. Jafarnezhadgero AA, Pourrahimghoroghchi A, Darvishani MA, Aali S, Dionisio VC. Analysis of ground reaction forces and muscle activity in individuals with anterior cruciate ligament reconstruction during different running strike patterns. Gait & Posture 2021; 90: 204-209.
  8. Mohammadi V, Letafatkar A, Sadeghi H, Jafarnezhadgero A, Hilfiker R. The effect of motor control training on kinetics variables of patients with non-specific low back pain and movement control impairment: Prospective observational study. Journal of bodywork and movement therapies 2017; 21(4): 1009-1016. [Persian]
  9. Stergiou N, Giakas G, Byrne JE, Pomeroy V. Frequency domain characteristics of ground reaction forces during walking of young and elderly females. Clinical Biomechanics 2002; 17(8): 615-617.
  10. Hamill J, McNiven SL. Reliability of selected ground reaction force parameters during walking. Human Movement Science 1990; 9(2): 117-131.
  11. Bojanic DM, Petrovacki-Balj BD, Jorgovanovic ND, Ilic VR. Quantification of dynamic EMG patterns during gait in children with cerebral palsy. Journal of neuroscience methods 2011; 198(2): 325-331.
  12. White R, Agouris I, Fletcher E. Harmonic analysis of force platform data in normal and cerebral palsy gait. Clinical Biomechanics 2005; 20(5): 508-516.
  13. Cohen J. Statistical power analysis for the behavioral sciences: Routledge; 2013.
  14. Jafarnezhadgero AA, Majlesi M, Azadian E. Gait ground reaction force characteristics in deaf and hearing children. Gait & posture 2017; 53: 236-240
  15. Winter DA. Biomechanics and motor control of human movement: John Wiley & Sons; 2009: 152-145.
  16. Solomonow M, Baten C, Smit J, Baratta R, et al. Electromyogram power spectra frequencies associated with motor unit recruitment strategies. Journal of Applied Physiology 1990; 68(3): 1177-1185.
  17. Majlesi M, Azadian E, Farahpour N, Jafarnezhad AA, Rashedi H. Lower limb muscle activity during gait in individuals with hearing loss. APESM 2017; 40(3): 659-665.
  18. Lam W, Leong JCY, Li Y, Hu Y, Lu W. Biomechanical and electromyographic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy. Gait & posture. 2005; 22(3): 189-197.
  19. Sadeghi A, Pourrazi H, Mafi S. Effect of Eight-Week Combined Strength-Balance Training on Muscle Strength, Balance and Quality of Life in Children with Monoplegic Cerebral Palsy. Rehabilitation Research in Nursing 2020; 7(2): 52-62. [Persian]
  20. Elhami M. Effect of motor dual task on the electromyographic activity of lower limb and trunk muscles during gait in cerebral palsy (CP) and healthy subjects. Studies in Medical Sciences 2021; 31(11): 836-846.
  21. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods 2007; 39(2): 175-191.
  22. Mohammadkhani-Pordanjani E, Arnould C, Raji P, Nakhostin Ansari N, Hasson S. Validity and reliability of the Persian ABILHAND-Kids in a sample of Iranian children with cerebral palsy. Disability and rehabilitation 2020; 42(12): 1744-1752.
  23. Dehghan L, Abdolvahab M, Bagheri H, Dalvand H. Inter rater reliability of Persian version of Gross Motor Function Classification System Expanded and Revised in patients with cerebral palsy. Daneshvar 2011; 18(6): 37-44.
  24. Tye C-Y, Lwanga SK, editors. Teaching health statistics: twenty lesson and seminar outlines. Teaching health statistics: twenty lesson and seminar outlines; 1986: 230.
  25. Association WM. Declaration of Helsinki. World Medical Association Declaration of Helsinki: Recommendations Guiding Medical Doctors in Biomedical Research Involving Human Subjects.(Adopted by the 18th World Medical Assembly, Helsinki, Finland, 1964 and as revised by the World Medical Assembly in Tokyo, Japan in 1975, in Venice, Italy in 1983, and in Hong Kong in 1989). Venice, Italy in. 1983.
  26. Association WM. Declaration of Helsinki, 41st World Medical Assembly. Hong Kong. 1989.
  27. Association WM. Declaration of Helsinki. Somerset West, South Africa, 1996; Edimburgh, Scotland, 2000.
  28. Association WM. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, Edinburgh, Scotland, October 2000. World Medical Association Recommendations Guiding Physicians in Biomedical Research Involving Human Subjects.
  29. Association WM. Washington DC: 2002. Declaration of Helsinki: ethical principles for medical research involving human subjects, as amended by the 52nd WMA Assembly, Edinburgh, Scotland. 2000.
  30. Association WM. Declaration of Helsinki, Tokyo. 2004.
  31. Declaration H. ICH guideline for good clinical practice. 59th WMA General Assembly, Seoul. Korea, October. 2008.
  32. Goodyear MD, Krleza-Jeric K, Lemmens T. The declaration of Helsinki. British Medical Journal Publishing Group; 2007. 624-625.
  33. Jafarnezhadgero AA, Shahverdi M, Madadi Shad M. The effectiveness of a novel Kinesio Taping technique on the ground reaction force components during bilateral drop landing in athletes with concurrent pronated foot and patella-femoral pain syndrome. JoAST 2017; 1(1): 22-29. [Persian]
  34. Pamukoff DN, Lewek MD, Blackburn JT. Greater vertical loading rate in obese compared to normal weight young adults. Clinical Biomechanics. 2016; 33: 61-65.
  35. Willwacher S, Goetze I, Fischer KM, Brüggemann G-P. The free moment in running and its relation to joint loading and injury risk. Footwear Science 2016; 8(1): 1-11.
  36. Robertson GE, Caldwell GE, Hamill J, Kamen G, Whittlesey S. Research methods in biomechanics: Human kinetics 2013: 53-64.
  37. Collins M, Xenophontos SL, Cariolou MA, Mokone GG, et al. The ACE gene and endurance performance during the South African Ironman Triathlons. Medicine and science in sports and exercise 2004; 36(8): 1314-1320.
  38. McGrath D, Judkins TN, Pipinos II, Johanning JM, Myers SA. Peripheral arterial disease affects the frequency response of ground reaction forces during walking. Clinical Biomechanics 2012; 27(10): 1058-1063.
  39. Wurdeman SR, Huisinga JM, Filipi M, Stergiou N. Multiple sclerosis affects the frequency content in the vertical ground reaction forces during walking. Clinical biomechanics 2011; 26(2): 207-212.
  40. Jafarnezhadgero AA, Abdollahpour DM. Effect of Texture Insole on the Frequency Spectrum of Ground Reaction Forces in Children with Autism Spectrum Disorder during Walking. SJRM 2020; 3(9): 102-111. [Persian]
  41. Cohen J. A power primer. Psychological bulletin. 1992; 112(1): 155.
  42. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of electromyography and Kinesiology 2000; 10(5): 361-374.
  43. Farahpour N, Jafarnezhadgero A, Allard P, Majlesi M. Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. Journal of Electromyography and Kinesiology 2018; 39: 35-41.
  44. Chuan CL, Penyelidikan J. Sample size estimation using Krejcie and Morgan and Cohen statistical power analysis: A comparison. Jurnal Penyelidikan IPBL 2006; 7(1): 78-86.
  45. Rosenbaum P, Paneth N, Leviton A, Goldstein M, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109(109): 8-14.
  46. Rose DH, Meyer A. Teaching every student in the digital age: Universal design for learning: ERIC; 2002: 125-201.
  47. Chiu M-C, Wang M-J. The effect of gait speed and gender on perceived exertion, muscle activity, joint motion of lower extremity, ground reaction force and heart rate during normal walking. Gait & posture 2007; 25(3): 385-392.
  48. Tahmasebi A, Raji P, Karimi MT. Effect of Visual Feedback on Static Standing Balance in Children with Spastic Diplegic Cerebral Palsy Compared to Normal Children. Health Rehabi. 2016; 1(2): 35-44.
  49. Brenneman EC, Maly MR. Identifying changes in gait waveforms following a strengthening intervention for women with knee osteoarthritis using principal components analysis. Gait & posture 2018; 59: 286-291.
  50. Qiu F, Cole MH, Davids KW, Hennig EM, et al. Effects of textured insoles on balance in people with Parkinson’s disease. PloS one 2013; 8(12) :1-8.
  51. Qu X. Impacts of different types of insoles on postural stability in older adults. Applied ergonomics 2015; 46: 38-43.
  52. Hatton AL, Dixon J, Rome K, Newton JL, Martin DJ. Altering gait by way of stimulation of the plantar surface of the foot: the immediate effect of wearing textured insoles in older fallers. Journal of foot and ankle research 2012; 5(1): 11.
  53. Vieira T, Botter A, Gastaldi L, Sacco IC, Martelli F, Giacomozzi C. Textured insoles affect the plantar pressure distribution while elite rowers perform on an indoor rowing machine. PloS one 2017; 12(11): 1-14.
  54. Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. British journal of sports medicine 2011; 45(9): 691-691.
  55. Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clinical biomechanics 2011; 26(1): 78-83.
  56. Lu WW, Hu Y, Luk KD, Cheung KM, Leong JC. Paraspinal muscle activities of patients with scoliosis after spine fusion: an electromyographic study. Spine 2002; 27(11): 1180-1185.
  57. Donker S, Mulder T, Nienhuis B, Duysens J. Adaptations in arm movements for added mass to wrist or ankle during walking. Experimental brain research 2002; 146(1): 26-31.
  58. Ebenbichler G, Kollmitzer J, Quittan M, Uhl F, et al. EMG fatigue patterns accompanying isometric fatiguing knee-extensions are different in mono-and bi-articular muscles. Electroencephalography and Clinical Neurophysiology/Electromyography and Motor Control 1998; 109(3): 256-262.
  59. Policy JF, Torburn L, Rinsky LA, Rose J. Electromyographic test to differentiate mild diplegic cerebral palsy and idiopathic toe-walking. Journal of Pediatric Orthopaedics 2001; 21(6): 784-789.
  60. Rose J, Martin JG, Torburn L, Rinsky LA, Gamble JG. Electromyographic differentiation of diplegic cerebral palsy from idiopathic toe walking: involuntary coactivation of the quadriceps and gastrocnemius. Journal of Pediatric Orthopaedics 1999; 19(5): 677.