title: Mirror visual feedback induces lower neuromuscular activity in children with spastic hemiparetic cerebral palsy.
abstract: The study examined the effects of mirror feedback information on neuromuscular activation during bimanual coordination in eight children with spastic hemiparetic cerebral palsy (SHCP) and a matched control group. The 'mirror box' creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. The study incorporated two additional visual feedback conditions by placing a glass or opaque screen between the arms. During bilateral symmetric circular arm movements mirror visual feedback induced lower neuromuscular intensities in the shoulder muscles of the less impaired arm of children with SHCP compared to the other visual conditions. In addition, the mirror lead to shorter relative durations of eccentric and concentric activity in the elbow muscles of the more impaired arm, whereas no effects of visual feedback were found in a matched control group. These results suggest that replacing veridical visual information of the more impaired arm with a mirror reflection of the less impaired arm improves the motor control of children with SHCP during interlimb coupling. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to: (1) increase ipsilateral motor cortex excitability and (2) congruence between afferent (visual) feedback and the internal copy of the motor commands.
authors.affiliation: Movement Science Group, School of Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford OX3 0BP, UK. mfeltham@brookes.ac.uk
authors.forename: Max G
authors.initials: MG
authors.lastname: Feltham
authors.forename: Annick
authors.initials: A
authors.lastname: Ledebt
authors.forename: Frederik J A
authors.initials: FJ
authors.lastname: Deconinck
authors.forename: Geert J P
authors.initials: GJ
authors.lastname: Savelsbergh
mesh_terms: D000293:Adolescent; D001132:Arm / Q000502:physiology; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy; D002648:Child; D004576:Electromyography; D025461:Feedback, Physiological / Q000502:physiology*; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007088:Illusions / Q000502:physiology*; D008297:Male; D009044:Motor Cortex / Q000502:physiology; D009048:Motor Skills / Q000502:physiology; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D012782:Shoulder / Q000502:physiology; D014796:Visual Perception / Q000502:physiology