Indiana University-Purdue University Indianapolis (IUPUI) / Background: Ambulation is critical to a child’s participation, development of selfconcept,
and quality of life. Children with cerebral palsy (CP) frequently exhibit
limitation in walking proficiency which has been identified as the primary physical
disability. Traditional rehabilitative treatment techniques to improve ambulation for
children with CP reveal inconsistent results. Driven gait orthosis (DGO) training is a
novel approach focusing on motor learning principles that foster cortical neural
plasticity.
Objective: The objectives are to determine if: (i) the lower extremity muscle activation
patterns of children with CP are similar to age-matched TD children in overground (OG)
walking, (ii) DGO training replicates muscle activation patterns in OG ambulation in TD
children, (iii) the lower extremity muscle activation patterns in OG walking of children
with CP are similar to their muscle activation patterns with DGO assistance, and (iv) DGO
training promotes unimpaired muscle activation patterns in children with CP.
Methods: Muscle activity patterns of the rectus femoris, semitendinosus, gluteus
maximus and gluteus medius were recorded in the OG and DGO walking conditions of
children with CP and age-matched TD. The gait cycles were identified and the data was
averaged to produce final average gait cycle time normalized values.
Results: In comparing the variability of the muscle activation patterns within the
subject groups, CP DGO walking was considerably lower than CP OG. In comparing the muscle activation patterns in each condition, consistent differences (p < .05) were noted
in terminal stance, pre-swing and initial swing phases of gait with the DGO condition
consistently revealing greater muscle unit recruitment.
Conclusion: The results indicate that training in the DGO provided the ability to practice
with measurably repetitive movement as evidenced by decreased variability. Consistent
differences were noted in muscle activation patterns in the terminal stance, pre-swing
and initial swing phases of gait when most of these muscles are primarily inactive. The
alteration in ground reaction force within the DGO environment may play a role in this
variance. With the goal of normalizing gait, it is important that the effect of these
parameters on ground reaction forces be considered in the use of DGO rehabilitation.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/19437 |
| Date | 05 1900 |
| Creators | Scheidler, Capi Seeger |
| Contributors | Altenburger, Peter, Bahamonde, Rafael, Miller, Kristine, Hamby, Deborah |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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