Quantifying Patient-Specific Changes in Neuromuscular Control in Cerebral Palsy
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cerebral Palsy
- Sponsor
- University of Washington
- Enrollment
- 55
- Locations
- 1
- Primary Endpoint
- Change in Walk Dynamic Motor Control Index 6-months After Orthopaedic Surgery
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Impaired neuromuscular control hinders movement for individuals with cerebral palsy and other neurological disorders. In this research, the investigators are developing new tools to quantify impaired neuromuscular control in cerebral palsy and evaluate changes after one of the most common treatments, orthopaedic surgery. The results from this research will empower clinicians to identify patient-specific factors that contribute to impaired movement and improve treatment and quality of life.
Detailed Description
The long-term goals of this research are to quantify patient-specific changes in neuromuscular control in order to optimize treatment planning and improve mobility for individuals with cerebral palsy (CP). As a first step, the aims of this proposal are to evaluate neuromuscular control before and after one of the most common treatments for individuals with CP, orthopaedic surgery. The investigators will evaluate if patient-specific measures of neuromuscular control, based upon the framework of muscle synergies, can predict improvements in walking ability after surgery. Further, investigators will determine whether neuromuscular control changes after surgery and if these changes contribute to improvements in movement. To achieve these goal the investigators will implement and test new tools to quantify neuromuscular control which integrate clinical gait analysis and two computational techniques: synergy analysis and dynamic musculoskeletal simulation. This research will provide the foundation to use measures of altered neuromuscular control to inform treatment planning, develop alternative treatments, and improve mobility in CP and other neurologic disorders.
Investigators
Katherine Steele
Assistant Professor, Mechanical Engineering
University of Washington
Eligibility Criteria
Inclusion Criteria
- •Diplegic cerebral palsy
- •Mild or Moderate Impairment, Gross Motor Function Classification System (GMFCS) Levels I-III
- •Will receive follow-up care and physical therapy within the Gillette Children's Specialty Healthcare system
Exclusion Criteria
- •Botulinum toxin injections, baclofen, or other similar treatments in the 3 months prior to pre-operative gait analysis
Outcomes
Primary Outcomes
Change in Walk Dynamic Motor Control Index 6-months After Orthopaedic Surgery
Time Frame: 6-months after individual's orthopaedic surgery
The Walk Dynamic Motor Control Index (Walk DMC) is a specific measurement calculated from electromyography during gait using nonnegative matrix factorization. A value of 100 indicates complexity of neuromuscular control similar to typically-developing peers and each 10 point deviation represents one standard deviation from typically-developing peers. Thus, a value of 80 would indicate that an individual's muscle coordination during gait is two standard deviations below the complexity of unimpaired individuals.
Change in Walk Dynamic Motor Control Index 1-year After Orthopaedic Surgery
Time Frame: 1-year after individual's orthopaedic surgery
The Walk Dynamic Motor Control Index (Walk DMC) is a specific measurement calculated from electromyography during gait using nonnegative matrix factorization. A value of 100 indicates complexity of neuromuscular control similar to typically-developing peers and each 10 point deviation represents one standard deviation from typically-developing peers. Thus, a value of 80 would indicate that an individual's muscle coordination during gait is two standard deviations below the complexity of unimpaired individuals.
Secondary Outcomes
- Change in Gait Deviation Index 6-months After Orthopaedic Surgery(6-months after individual's orthopaedic surgery)
- Change in Gait Deviation Index 1-year After Orthopaedic Surgery(1-year after individual's orthopaedic surgery)