Lower limb muscle fatigue after uphill walking in children with unilateral spastic cerebral palsy

PLoS One. 2022 Dec 6;17(12):e0278657. doi: 10.1371/journal.pone.0278657. eCollection 2022.

Abstract

Fatigue during walking is a common complaint in cerebral palsy (CP). The primary purpose of this study is to investigate muscle fatigue from surface electromyography (sEMG) measurements after a treadmill-based fatigue protocol with increasing incline and speed in children with CP with drop foot. The secondary purpose is to investigate whether changes in sagittal kinematics of hip, knee and ankle occur after fatigue. Eighteen subjects with unilateral spastic CP performed the protocol while wearing their ankle-foot orthosis and scored their fatigue on the OMNI scale of perceived exertion. The median frequency (MF) and root mean square (RMS) were used as sEMG measures for fatigue and linear mixed effects model were applied. The MF was significantly decreased in fatigued condition, especially in the affected leg and in the tibialis anterior and peroneus longus muscle. The RMS did not change significantly in fatigued condition, while the OMNI fatigue score indicated patients felt really fatigued. No changes in sagittal kinematics of hip, knee and ankle were found using statistical non-parametric mapping. In conclusion, the current fatigue protocol seems promising in inducing fatigue in a population with CP with drop foot and it could be used to expand knowledge on muscle fatigue during walking in CP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Palsy* / complications
  • Child
  • Humans
  • Lower Extremity
  • Muscle Fatigue
  • Walking

Grants and funding

There are no competing interests to declare. This study is part of a larger study entitled “Functional electrical stimulation of the ankle dorsiflexors during walking in children with unilateral spastic cerebral palsy: a randomized crossover intervention study” (ClinicalTrials.gov number NCT03440632) which is funded by HandicapNL (formerly Revalidatiefonds, project number R201605614, RJV), in collaboration with the Cornelia Stichting. No sponsor/funder played any role in study design, data collection and analysis, decision to publish and preparation of the manuscript.