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. 2022 Dec 6;17(12):e0278657.
doi: 10.1371/journal.pone.0278657. eCollection 2022.

Lower limb muscle fatigue after uphill walking in children with unilateral spastic cerebral palsy

I Moll  1   2   3 , J M N Essers  2 , R G J Marcellis  4 , R H J Senden  4 , Y J M Janssen-Potten  5   6 , R J Vermeulen  1   3 , K Meijer  2
Affiliations

Lower limb muscle fatigue after uphill walking in children with unilateral spastic cerebral palsy

I Moll et al. PLoS One. .

Abstract

Fatigue during walking is a common complaint in cerebral palsy (CP). The primary purpose of this study is to investigate muscle fatigue from surface electromyography (sEMG) measurements after a treadmill-based fatigue protocol with increasing incline and speed in children with CP with drop foot. The secondary purpose is to investigate whether changes in sagittal kinematics of hip, knee and ankle occur after fatigue. Eighteen subjects with unilateral spastic CP performed the protocol while wearing their ankle-foot orthosis and scored their fatigue on the OMNI scale of perceived exertion. The median frequency (MF) and root mean square (RMS) were used as sEMG measures for fatigue and linear mixed effects model were applied. The MF was significantly decreased in fatigued condition, especially in the affected leg and in the tibialis anterior and peroneus longus muscle. The RMS did not change significantly in fatigued condition, while the OMNI fatigue score indicated patients felt really fatigued. No changes in sagittal kinematics of hip, knee and ankle were found using statistical non-parametric mapping. In conclusion, the current fatigue protocol seems promising in inducing fatigue in a population with CP with drop foot and it could be used to expand knowledge on muscle fatigue during walking in CP.

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Conflict of interest statement

No conflicts of interests to declare. The authors don’t have financial relationships with other persons or organizations that might have inappropriately influenced our work presented in this manuscript.

Figures

Fig 1
Fig 1. Example of a raw sEMG signal of the gastrocnemius muscle.
Fig 2
Fig 2
Changes in sEMG median frequency (MF, panel A) and root mean square (RMS, panel B) between the comfortable and fatigued condition; for the affected leg (graphs on the left) and unaffected leg (graphs on the right). The change is calculated as the difference between the value after the fatigue protocol minus the value before the fatigue protocol per muscle per patient and displayed on the x-axis. The y-axis shows the different muscles. Abbreviations used: RecF: rectus femoris; VasL: vastus lateralis; SemT: semitendinosus; BicF: biceps femoris; GasM: gastrocnemius; Sole: soleus; TibA: tibialis anterior; PerL: peroneus longus.
Fig 3
Fig 3
Mean sagittal plane kinematics of the ankle, knee and hip of the affected leg (graphs on the left) and unaffected leg (graphs on the right), for the comfortable (black line) and fatigued condition (grey line). N = 18.
See this image and copyright information in PMC

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