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Lower Limb Antagonist Muscle Co-Activation and its Relationship with Gait Parameters in Cerebellar Ataxia

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Abstract

Increased antagonist muscle co-activation, seen in motor-impaired individuals, is an attempt by the neuromuscular system to provide mechanical stability by stiffening joints. The aim of this study was to investigate the co-activation pattern of the antagonist muscles of the ankle and knee joints during walking in patients with cerebellar ataxia, a neurological disease that strongly affects stability. Kinematic and electromyographic parameters of gait were recorded in 17 patients and 17 controls. Ankle and knee antagonist muscle co-activation indexes were measured throughout the gait cycle and during the sub-phases of gait. The indexes of ataxic patients were compared with those of controls and correlated with clinical and gait variables. Patients showed increased co-activity indexes of both ankle and knee muscles during the gait cycle as well as during the gait sub-phases. Both knee and ankle muscle co-activation indexes were positively correlated with disease severity, while ankle muscle co-activation was also positively correlated with stance and swing duration variability. Significant negative correlations were observed between the number of self-reported falls per year and knee muscle co-activation. The increased co-activation observed in these cerebellar ataxia patients may represent a compensatory strategy serving to reduce gait instability. Indeed, this mechanism allows patients to reduce the occurrence of falls. The need for this strategy, which results in excessive muscle co-contraction, increased metabolic costs and cartilage degeneration processes, could conceivably be overcome through the use of supportive braces specially designed to provide greater joint stability.

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Conflict of Interest

The authors declared no potential conflicts of interest with respect to the authorship and/or publication of this article.

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Authors and Affiliations

  1. Fondazione Don Gnocchi, Milan, Italy

    Silvia Mari & Luca Padua

  2. Rehabilitation Centre Policlinico Italia, Rome, Italy

    Mariano Serrao & Carmela Conte

  3. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy

    Mariano Serrao, Carlo Casali & Gianluca Coppola

  4. IRCCS C. Mondino, Department of Neuroscience, University of Pavia, Pavia, Italy

    Carmela Conte & Giorgio Sandrini

  5. Centre of Space Bio-medicine, University of Rome Tor Vergata, Rome, Italy

    Giovanni Martino

  6. INAIL, Department of Occupational Medicine, Monte Porzio Catone, Rome, Italy

    Alberto Ranavolo & Francesco Draicchio

  7. IRCCS Neuromed, Pozzilli, Italy

    Francesco Pierelli

  8. Policlinico Italia, Piazza del Campidano, 00162, Rome, Italy

    Mariano Serrao

Authors
  1. Silvia Mari
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  2. Mariano Serrao
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  3. Carlo Casali
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  4. Carmela Conte
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  5. Giovanni Martino
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  6. Alberto Ranavolo
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  9. Luca Padua
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Correspondence to Mariano Serrao.

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Silvia Mari and Mariano Serrao are equal contributors

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Mari, S., Serrao, M., Casali, C. et al. Lower Limb Antagonist Muscle Co-Activation and its Relationship with Gait Parameters in Cerebellar Ataxia. Cerebellum 13, 226–236 (2014). https://doi.org/10.1007/s12311-013-0533-4

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  • DOI: https://doi.org/10.1007/s12311-013-0533-4

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