A longitudinal analysis of selective motor control during gait in individuals with cerebral palsy and the relation to gait deviations.

Objective: To investigate longitudinal changes in selective motor control during gait (SMCg) in individuals with cerebral palsy (CP), and to assess if they are related to changes in gait deviations.
Method: Twenty-three children/adolescents with spastic CP (mean ± SD age = 9.0±2.5 years) and two 3D gait assessments (separated by 590±202 days) with no interim surgical intervention, were included. SMCg was assessed using muscle synergy analysis to determine the dynamic motor control index (walk-DMC). Gait deviation was assessed using the Gait profile score (GPS) and Gait variable scores (GVS).
Results: There were no mean changes in walk-DMC score, GPS or GVS between assessments. However, changes in walk-DMC scores in the more involved leg related to changes in hip flexion-extension and hip internal-external GVS (rp = -0.56; p = 0.017 and rp = 0.65; p = 0.004, respectively).
Conclusions: On average, there were no significant longitudinal changes in SMCg. However, there was considerable variability between individuals, which may relate to changes in hip joint kinematics. This suggests that a combination of neural capacity and biomechanical factors influence lower limb muscle co-activation in individuals with CP, with a potential important role for the hip muscles. These findings highlight the importance of taking an individualized approach when evaluating SMCg in individuals with CP.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Sorek et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)