ABSTRACT
PURPOSE: To present a new walking aid with axillary support (WAAS) for children with cerebral palsy (CP) and to investigate its impact on the lower limb muscles activation in the gait of children with CP. METHOD: Six children with spastic diparesis due to CP performed a straight line walking course in two situations: with and without using the WAAS. Each course was repeated three times for both situations, and electromyography (EMG) activity of quadriceps, hamstrings, tibialis anterior and gastrocnemius were recorded during all trials. RESULTS: The use of WAAS significantly increased the EMG activity of the quadriceps and hamstrings during stance phase and tibialis anterior during swing phase, with no significant increase in gastrocnemius activation. CONCLUSION: The use of WAAS improved the synergism of lower limbs muscles of children with CP by reducing the coactivation of antagonistic muscles, especially during the swing phase of gait. Providing a walking aid with improved trunk stability may enable children with CP to improve muscular synergism and walking ability, thus favoring independent mobility, with possible gains in social participation and quality of life. IMPLICATIONS FOR REHABILITATION: Children with cerebral palsy have problems with the development of normal gait, as a result of the reduced motor control and the impaired muscle synergism of the lower limbs. Standard walking aids do not provide proper trunk stability for this group of children. In a relatively small sample of children with cerebral palsy, a walking aid with axillary support was shown to be beneficial for the muscular synergism of the lower limbs during gait.
Subject(s)
Cerebral Palsy/rehabilitation , Disabled Children/rehabilitation , Electromyography/methods , Gait/physiology , Muscle, Skeletal/physiopathology , Orthotic Devices/trends , Walking/physiology , Biomechanical Phenomena , Cerebral Palsy/physiopathology , Child , Child, Preschool , Female , Humans , MaleABSTRACT
O objetivo deste estudo é a análise eletromiográfica (EMG) da atividade muscular durante a marcha normal, usando diferentes tipos de calçados e descalço, no intuito de observar alterações biomecânicas na marcha. A análise foi realizada com 22 sujeitos normais do sexo feminino com idade ente 08 e 12 anos, usando eletrodos de superfície para medição de dados eletromiográficos. Os três músculos selecionados para estudo foram tibial anterior, gastrocnêmio (tríceps sural) e músculos lombares (paravertebrais). Foi feita a análise com os sujeitos deambulando de forma natural, primeiro descalços, depois usando salto baixo e finalmente salto alto. os dados foram gravados durante a transição da fase de oscilação para a fase de apoio a marcha, no momento do toque de calcanhar. Tibial anterior (TA) e o gastrocnêmio (TS) mostraram um aumento da atividade muscular durante a marcha com salto alto, quando comparada a marcha descalça. Durante a marcha com salto baixo, a atividade muscular de TA e TS foi diferente da marcha descalça. Os músculos lombares não mostraram uma alteração significativa. Nós pudemos concluir que a atividade muscular de TA e TS é diferente, usando diferentes tipos de calçados e descalço, durante a mesma fase da marcha. os resultados destaas alterações biomecânicas possivelmente podem ser relatados em estudos futuros.
The aim of this study was an eletromiographic (EMG) analysis of music activity during normal human gait wearing different of shoes and bare feet, in order to observe biomechanical changes of the gait. The analysis was made with 22 normal femalesubjects, 08-12 years old, using EMG measurement by surface electrodes. The three muscles selected for study were tibialis anterior, gastrocnemius (triceps surae) lower back muscles (paravertebralis). The data were registered when the subjects were walking on normal and natural speed, at first bare feet; wearing small heel shoes and then wearing high heels shoes. The data were recorded during swing stane transition of gait cycle, at heel contact. Tibialis anterior (TA) and gastrocnemius (TS) showed an increase of muscle activity during the high heel gaitwhen comparing with bare foot gait. Duriing small heel gait the muscle activity of TA and TS was different than bare foot gait. The lower back muscle showed no significant alteration. We could conclude that the muscle activity of TA and TS is different wearing different type of shoes and bare feet at the same phase. The results of this biomechanical changes possible would be report in future studies.
