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Gait Asymmetry in Winters Group I Hemiplegic Children: Role of Tibialis Anterior

  • Francesco Di Nardo
  • Alessandro Mengarelli
  • Annachiara Strazza
  • Marta Malavolta
  • Federica Verdini
  • Stefano Cardarelli
  • Laura Burattini
  • Alberto Nascimbeni
  • Sandro Fioretti
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 68/2)

Abstract

Hemiplegia is a neurological disorder that occurs quite often in children, affecting up to one child in one thousand. Typically, only one side of the body is affected by hemiplegia, while the other side is maintaining an apparently normal behavior. Purpose of present analysis was assessing gait asymmetry in group I (W1) hemiplegic children according to Winters classification, where W1 is characterized by presence of drop foot in swing in the hemiplegic side. Asymmetry was quantified by differences between hemiplegic and non-hemiplegic side in terms of foot-floor contact and electromyographic (EMG) activity. Surface EMG from tibialis anterior (TA) and foot-floor contact data were acquired in ten hemiplegic W1 children during walking to fulfill this aim. An exceptional number of strides was analyzed to consider the data variability, expected in W1 (mean ± SD = 287 ± 62 strides for each child, more than 3000 in total). Statistical gait analysis, a recent methodology performing a statistical characterization of gait, was applied to process EMG data. The research was undertaken in compliance with ethical principles of Helsinki Declaration and approved by institutional expert committee. Results showed that asymmetries were detected in basographic data: W1 children showed a significant decrease (p < 0.05) of strides with normal foot-floor contact (HFPS sequence: heel contact, flat-foot contact, push-off, swing) in hemiplegic side with respect to non-hemiplegic side. Also, TA recruitment presented asymmetries during walking, characterized by a curtailed, less frequent activity (p < 0.05) during terminal swing and a lack of activity at heel strike in hemiplegic side, with respect to non-hemiplegic side. In conclusion, present study suggested that walking in W1 children is characterized by asymmetries in both foot-floor contact patterns and TA recruitment.

Keywords

Surface EMG Hemiplegia Children Statistical gait analysis 

Notes

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

References

  1. 1.
    Ostensjø S, Carlberg EB, Vøllestad NK (2004) Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities. Dev Med Child Neurol 46: 580–589.Google Scholar
  2. 2.
    Winters TF, Gage JR, Hicks R (1987) Gait patterns in spastic hemiplegiain children and young adults. J. Bone and Joint Surg 69: 437–441.Google Scholar
  3. 3.
    Agostini V, Nascimbeni A, Gaffuri A, Knaflitz M (2015) Multiple gait patterns within the same Winters class in children with hemiplegic cerebral palsy. Clin Biomech 30: 908–914.Google Scholar
  4. 4.
    Patikas D, Wolf S, Döderlein L (2005) Electromyographic evaluation of the sound and involved side during gait of spastic hemiplegic children with cerebral palsy. Eur J Neurol 12: 691–699.Google Scholar
  5. 5.
    Di Nardo F, Agostini V, Strazza A, Nascimbeni A, Knaflitz M, Burattini L, Fioretti S (2017) Gait asymmetry in Winters’ group I hemiplegic children.. IFMBE Proceedings 65: 976–979.Google Scholar
  6. 6.
    Winter DA (1990) “Biomechanics and motor control of human movement”, 2nd ed., Wiley, New York.Google Scholar
  7. 7.
    Bonato P, D’Alessio T, Knaflitz M (1998) A statistical method for the measurement of muscle activation intervals from surface myoelectric signal during gait. IEEE Trans Biomed Eng 45: 287–299.Google Scholar
  8. 8.
    Agostini V, Balestra G, Knaflitz M (2014) Segmentation and classification of gait cycles. IEEE Trans Neural Syst Rehabil Eng 22: 946–952.Google Scholar
  9. 9.
    Agostini V, Nascimbeni A, Gaffuri A, Imazio P, Benedetti MG, Knaflitz M (2010) Normative EMG activation patterns of school-age children during gait. Gait Posture 32: 285–289.Google Scholar
  10. 10.
    Di Nardo F, Mengarelli A, Strazza A, Agostini V, Knaflitz M, Burattini L, Fioretti S (2017) A new parameter for quantifying the variability of surface electromyographic signals during gait: The occurrence frequency. J. Electromyogr. Kinesiol 36: 25–33.Google Scholar
  11. 11.
    Di Nardo F, Fioretti S (2014) Emg-based analysis of treadmill and ground walking in distal leg muscles. IFMBE Proceedings 41: 611–614.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Francesco Di Nardo
    • 1
  • Alessandro Mengarelli
    • 1
  • Annachiara Strazza
    • 1
  • Marta Malavolta
    • 1
  • Federica Verdini
    • 1
  • Stefano Cardarelli
    • 1
  • Laura Burattini
    • 1
  • Alberto Nascimbeni
    • 2
  • Sandro Fioretti
    • 1
  1. 1.Department of Information EngineeringUniversità Politecnica delle MarcheAnconaItaly
  2. 2.Rehabilitation Unit, Ospedale S. Croce, A.S.L. TO5Moncalieri (TO), TorinoItaly

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