Children With Cerebral Palsy Have Greater Stride-to-Stride Variability of Muscle Synergies During Gait Than Typically Developing Children: Implications for Motor Control Complexity.
Yushin Kim, Thomas C Bulea, Diane L Damiano
PMID 30223739WHAT IT FOUND
Children with cerebral palsy show greater stride-to-stride variability in muscle synergy patterns than typically developing peers.
Their walking uses fewer total synergies but distributes them across more inconsistent structures, suggesting less stable motor control rather than just weaker muscles.
Key findings
01The normalized cluster number, representing stride-to-stride variability of synergies, was significantly higher in children with CP than in typically developing children.
02Children with CP had a significantly lower mean number of synergies per stride compared to typically developing children.
03Variability in individual muscle EMG and joint angles did not differ significantly between the groups, pointing to differences in synergy structure rather than raw muscle activation or movement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was small, particularly the typically developing control group (n=8). Only eight EMG channels were used, which may not capture the full complexity of muscle activation compared to studies using more channels. The study included only children with GMFCS Level I and II, so results may not apply to those with more severe mobility limitations. Fatigue may have influenced stride-to-stride variability, although random selection of cycles was used to mitigate this. The study design is cross-sectional and observational, so it cannot determine if reducing synergy variability improves function.
Declared interests
No specific conflicts of interest or funding sources are detailed in the provided text, though the publication types list NIH and non-US government support.
The easy way to misread this
Do not assume that children with CP have less complex motor control overall. The study found they use fewer synergies on average but distribute them across more variable structures, suggesting a different, perhaps less stable, control strategy rather than a simple deficit.