HSP gait due to simultaneous muscle contractions

Posted - September 2017 in Living with HSP - Management & Treatment News

Linked to walking ability and energy expenditure

 

Simultaneous contractions of the muscles surrounding both the knee and ankle joints during walking is identified as the specific abnormality causing HSP gait in this Italian study of 23 HSPers and 23 non-HSP people (controls). Measures of these contractions taken during all phases of walking correlate with clinical measures of spasticity.

 

The greater these simultaneous contractions, the greater the energy expended through walking, which correlates with:

  • slower walking pace and distance

  • greater fatigue and

  • slower recovery after walking.

 

Abstract

BACKGROUND:

The aim of this study was to investigate the lower limb muscle co-activation and its relationship with muscle spasticity, gait performance, and metabolic cost in patients with hereditary spastic paraparesis.

 

METHODS:

Kinematic, kinetic, electromyographic and energetic parameters of 23 patients and 23 controls were evaluated by computerized gait analysis system. We computed ankle and knee antagonist muscle co-activation indexes throughout the gait cycle and during the sub-phases of gait. Energy consumption and energy recovery were measured as well. In addition to the correlation analysis between co-activation indexes and clinical variables, correlations between co-activation indexes and time-distance, kinematic, kinetic, and energetic parameters were estimated.

 

FINDINGS:

Increased co-activity indexes of both knee and ankle muscles throughout the gait cycle and during the sub-phases of gait were observed in patients compared with controls. Energetic parameters were significantly higher in patients than in controls. Both knee and ankle muscle co-activation indexes were positively correlated with knee and ankle spasticity (Ashworth score), respectively. Knee and ankle muscle co-activation indexes were both positively correlated with energy consumption and both negatively correlated with energy recovery.

 

INTERPRETATION:

Positive correlations between the Ashworth score and lower limb muscle co-activation suggest that abnormal lower limb muscle co-activation in patients with hereditary spastic paraparesis reflects a primary deficit linked to lower limb spasticity. Furthermore, these abnormalities influence the energetic mechanisms during walking. Identifying excessive muscle co-activation may be helpful in individuating the rehabilitative treatments and designing specific orthoses to restrain spasticity.

 

 

SOURCE: Clin Biomech (Bristol, Avon). 2017 Jul 29;48:63-72. doi: 10.1016/j.clinbiomech.2017.07.013. [Epub ahead of print] Copyright © 2017 Elsevier Ltd. All rights reserved. PMID: 28779695

 

Increased lower limb muscle co-activation reduces gait performance and increases metabolic cost in patients with hereditary spastic paraparesis.

 

Rinaldi M1, Ranavolo A2, Conforto S3, Martino G4, Draicchio F2, Conte C5, Varrecchia T6, Bini F7, Casali C8, Pierelli F9, Serrao M10.

 

1 Department of Engineering, Roma TRE University, Via Ostiense 159, 00154 Rome, Italy; Rehabilitation Centre, Policlinico Italia, Piazza del Campidano 6, 00162 Rome, Italy. Electronic address: mar[email protected]

2 Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.

3 Department of Engineering, Roma TRE University, Via Ostiense 159, 00154 Rome, Italy. Electronic address: [email protected]

4 Centre of Space Bio-Medicine, University of Rome Tor Vergata, Via Orazio Raimondo 18, 00173 Rome, Italy; Laboratory of Neuromotor Physiology, Istituto Di Ricovero e Cura a Carattere Scientifico Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy. Electronic address: [email protected]

5 Fondazione Don Gnocchi, Piazzale Morandi 6, 20121 Milan, Italy.

6 Department of Engineering, Roma TRE University, Via Ostiense 159, 00154 Rome, Italy; Rehabilitation Centre, Policlinico Italia, Piazza del Campidano 6, 00162 Rome, Italy.

7 Department of Mechanical and Aerospace Engineering, Mechanical & Thermal Measurement Lab, University of Rome Sapienza, Via Eudossiana 18, 00184 Rome, Italy. Electronic address: [email protected]

8 Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 04100 Latina, Italy. Electronic address: [email protected]

9 Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 04100 Latina, Italy. Electronic address: [email protected]

10 Rehabilitation Centre, Policlinico Italia, Piazza del Campidano 6, 00162 Rome, Italy; Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 04100 Latina, Italy.

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