title: Muscle synergies and complexity of neuromuscular control during gait in cerebral palsy.
abstract: OBJECTIVE
  Individuals with cerebral palsy (CP) have impaired movement due to a brain injury near birth. Understanding how neuromuscular control is altered in CP can provide insight into pathological movement. We sought to determine if individuals with CP demonstrate reduced complexity of neuromuscular control during gait compared with unimpaired individuals and if changes in control are related to functional ability.
  
  
  METHODS
  Muscle synergies during gait were retrospectively analyzed for 633 individuals (age range 3.9-70y): 549 with CP (hemiplegia, n=122; diplegia, n=266; triplegia, n=73; quadriplegia, n=88) and 84 unimpaired individuals. Synergies were calculated using non-negative matrix factorization from surface electromyography collected during previous clinical gait analyses. Synergy complexity during gait was compared with diagnosis subtype, functional ability, and clinical examination measures.
  
  
  RESULTS
  Fewer synergies were required to describe muscle activity during gait in individuals with CP compared with unimpaired individuals. Changes in synergies were related to functional impairment and clinical examination measures including selective motor control, strength, and spasticity.
  
  
  CONCLUSIONS
  Individuals with CP use a simplified control strategy during gait compared with unimpaired individuals. These results were similar to synergies during walking among adult stroke survivors, suggesting similar neuromuscular control strategies between these clinical populations.
authors.affiliation: Mechanical Engineering, University of Washington, Seattle, WA, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Steele
authors.affiliation: James R. Gage Center for Gait & Motion Analysis, Gillette Children's Specialty Healthcare, St. Paul, MN, USA.|Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Rozumalski
authors.affiliation: James R. Gage Center for Gait & Motion Analysis, Gillette Children's Specialty Healthcare, St. Paul, MN, USA.|Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010243:Paralysis / Q000503:physiopathology*; D011782:Quadriplegia / Q000503:physiopathology; D055815:Young Adult