Lower limb muscle fatigue during walking in children with cerebral palsy.
Maaike M Eken, Siri M Braendvik, Ellen Marie Bardal and 3 others
PMID 30156008WHAT IT FOUND
During short walks, children with cerebral palsy showed larger fatigue signs in lower leg muscles than peers, especially the more affected leg.
Upper leg muscles did not show fatigue. This is observational, not evidence strength training helps.
Key findings
01During walking, EMG signs of fatigue increased more per gait cycle in the tibialis anterior, gastrocnemius medialis, and soleus of the most affected leg of children with cerebral palsy than in typically developing children.
02The least affected leg of children with cerebral palsy also showed larger EMG changes per gait cycle than typically developing children in the soleus and gastrocnemius medialis.
03Children with cerebral palsy covered 302m during the walking test, while typically developing children covered 335m.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was small and heterogeneous, and mild and moderate cerebral palsy were not compared separately. The number of typically developing children recruited and included differs, and the reason is not stated. The study measured EMG changes during one self-paced walk, so it did not test longer or more demanding daily-life walking. Ankle-foot orthoses were used when needed, and their contribution was not separated. The children included were relatively well functioning and often did not report fatigue, so results may not apply to more affected children or adolescents and adults. The study was observational and did not test whether lower-leg strength training reduces fatigue. The paper reports EMG signs of fatigue, not a direct measure of how much fatigue the child feels or how much it limits walking.
Declared interests
Funding was provided by the Norwegian Research Council, the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and the St Olavs Hospital Research Fund.
The easy way to misread this
Do not conclude that lower-leg strength training will reduce walking fatigue in children with cerebral palsy. This paper observed EMG changes during walking and did not test any treatment.