Quantifying Patient-specific Changes in Neuromuscular Control in Cerebral Palsy: Adaptation and Biofeedback During Gait
University of Washington
Summary
This research aims to evaluate walking function in children with cerebral palsy (CP). The researchers want to understand how children with CP adapt and learn new ways of moving. They have previously found that measuring how a person controls their muscles is important for assessing walking ability and response to interventions. In these studies, they will adjust the treadmill belt speeds and/or provide real-time feedback to evaluate how a child can alter their movement. The feedback will include a wearable exoskeleton that provides resistance to the ankle and audio and visual cues based on sensors that record muscle activity. This research will investigate three goals: first, to measure how children with CP adapt their walking; second, to see if either repeated training or orthopedic surgery can improve adaptation rates; and third, to determine if individual differences in adaptation relate to improvements in walking function after treatment. This research will help develop better treatments to enhance walking capacity and performance for children with CP.
Description
Prior research has shown that children with cerebral palsy (CP) use simplified motor control strategies compared to nondisabled (ND) peers, and that these differences in motor control are associated with walking function. While we can quantify motor control during activities like walking, the processes by which a child with CP adapts and learns new movement patterns are poorly understood. This research will use two paradigms to evaluate adaptation and motor learning in children with CP: walking on a split-belt treadmill and responding to multimodal biofeedback. Walking on a split-belt treadmi…
Eligibility
- Age range
- 7–18 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Diagnosis of bilateral cerebral palsy that impacts both legs * Gross Motor Functional Classification System Level II * No surgery or lower-extremity injuries 12 months prior to enrollment * No botulinum toxin injections in prior 3 months * No prior selective dorsal rhizotomy surgery * No history of seizures or cardiac conditions that would preclude walking on a treadmill for 20 minutes * No current pain that hinders walking
Interventions
- DeviceBiomotum Spark: Robotic ankle resistance
Robotic ankle exoskeleton that provides resistance to ankle plantarflexion.
- DeviceAudiovisual Biofeedback
Electromyography recordings from the plantarflexor muscles are used to provide audio feedback via a sound that plays when muscle activity is above target and a visual bar that displays real-time muscle activity.
- ProcedureMultilevel Orthopedic Surgery
Musculoskeletal surgeries to address alignment, contracture, and other lower-extremity impairments. This study does not impact surgical decision making but evaluates changes in gait before and after surgery.
Location
- Gillette Children'sSaint Paul, Minnesota