Mehrdad Davoudi (Heidelberg), Firooz Salami (Heidelberg), Robert Reisig (Heidelberg), Dimitrios A. Patikas (Thessaloniki / GR), Prof. Dr. Sebastian Wolf (Heidelberg)
Abstract-Text (inkl. Referenzen und Bildunterschriften)
Introduction
Electromyography (EMG) serves as a noninvasive and clinically relevant method for assessing muscle activity. In individuals with cerebral palsy (CP), simultaneous 3D gait analysis coupled with EMG measurements is frequently employed to understand muscle function and aiding in treatment decision-making. Integrating EMG data from the rectus femoris (RF) muscle with gait and clinical data, surgeons developed a predictive model for RF transfer surgery outcomes. However, there is still a need for an approach that can assist clinicians by providing an objective analysis and interpretation of the EMG signals.
Aim
This study aimed to analyze the EMG data of patients with CP using cluster analysis, and to evaluate the relationship between common CP gait abnormalities, changes in gait over time, and the identified clusters.
Methods
The retrospective gait data of CP patients were divided into two groups: initial examination (E1, 881patients) and subsequent examination (E2, 377patients). Envelope-style EMG data for the RF were collected. Using PCA and a PSO-K-means algorithm, main clusters were identified. Patients were then categorized into crouch, jump, recurvatum, stiff, and mild gait for further analysis.
Results
Clusters displayed distinct EMG patterns: a notable peak during mid-swing (L1), sustained activity in stance (L2), and another peak during loading response (L3) (Table 1). L2 contained 76% (E1) and 92% (E2) of crouch patients. Comparing crouch patterns in L2-E1 and L2-E2 revealed two groups: persistent crouch (G1) and improved patients at E2 (G2). G1 showed significantly higher RF activity (20-45% gait cycle) than G2 (p=0.025)(Table 2).
Conclusion
A higher probability of improvement in crouch gait may be linked to decreased RF activity during the stance phase. Our findings offer a potential approach to enhance clinical decision-making in the treatment of CP patients. This research was funded by German Research Foundation (DFG) (no:WO1624/8-1).