Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy.
INTRODUCTION: Variability in task output is a ubiquitous characteristic that results from non-continuous motor neuron firing during muscular force generation. However, variability can also be attributed to errors in control and coordination of the motor neurons themselves in diseases such as cerebra...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3724918?pdf=render |
| _version_ | 1819088542987452416 |
|---|---|
| author | Mustafa Sinan Bakir Franziska Gruschke William R Taylor Ernst Johannes Haberl Ilya Sharankou Carsten Perka Julia F Funk |
| author_facet | Mustafa Sinan Bakir Franziska Gruschke William R Taylor Ernst Johannes Haberl Ilya Sharankou Carsten Perka Julia F Funk |
| author_sort | Mustafa Sinan Bakir |
| collection | DOAJ |
| description | INTRODUCTION: Variability in task output is a ubiquitous characteristic that results from non-continuous motor neuron firing during muscular force generation. However, variability can also be attributed to errors in control and coordination of the motor neurons themselves in diseases such as cerebral palsy (CP). Selective dorsal rhizotomy (SDR), a neurosurgical approach to sever sensory nerve roots, is thought to decrease redundant or excessive afferent signalling to intramedullary neurons. In addition to its demonstrated ability to reduce muscular spasticity, we hypothesised that SDR is able to decrease variability during gait, the most frequent functional motor activity of daily living. METHODS: Twelve CP children (aged 6.1 ± 1.3 yrs), who underwent SDR and performed gait analysis pre- and 12 months postoperatively, were compared to a control group of eleven typically developing (TD) children. Coefficients of variability as well as mean values were analysed for: temporal variables of gait, spatial parameters and velocity. RESULTS: Gait parameters of cadence (p = 0.006) and foot progression angle at mid-stance (p = 0.041) changed significantly from pre- to post-SDR. The variability of every temporal parameter was significantly reduced after SDR (p = 0.003-0.049), while it remained generally unchanged for the spatial parameters. Only a small change in gait velocity was observed, but variability in cadence was significantly reduced after SDR (p = 0.015). Almost all parameters changed with a tendency towards normal, but differences between TD and CP children remained in all parameters. DISCUSSION: The results confirm that SDR improves functional gait performance in children with CP. However, almost exclusively, parameters of temporal variability were significantly improved, leading to the conjecture that temporal variability and spatial variability may be governed independently by the motor cortex. As a result, temporal parameters of task performance may be more vulnerable to disruption, but also more responsive to treatment success of interventions such as SDR. |
| first_indexed | 2024-12-21T21:53:42Z |
| format | Article |
| id | doaj.art-db7df5322b9340a9a3c821a2a0254f82 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T21:53:42Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-db7df5322b9340a9a3c821a2a0254f822022-12-21T18:49:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0187e6950010.1371/journal.pone.0069500Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy.Mustafa Sinan BakirFranziska GruschkeWilliam R TaylorErnst Johannes HaberlIlya SharankouCarsten PerkaJulia F FunkINTRODUCTION: Variability in task output is a ubiquitous characteristic that results from non-continuous motor neuron firing during muscular force generation. However, variability can also be attributed to errors in control and coordination of the motor neurons themselves in diseases such as cerebral palsy (CP). Selective dorsal rhizotomy (SDR), a neurosurgical approach to sever sensory nerve roots, is thought to decrease redundant or excessive afferent signalling to intramedullary neurons. In addition to its demonstrated ability to reduce muscular spasticity, we hypothesised that SDR is able to decrease variability during gait, the most frequent functional motor activity of daily living. METHODS: Twelve CP children (aged 6.1 ± 1.3 yrs), who underwent SDR and performed gait analysis pre- and 12 months postoperatively, were compared to a control group of eleven typically developing (TD) children. Coefficients of variability as well as mean values were analysed for: temporal variables of gait, spatial parameters and velocity. RESULTS: Gait parameters of cadence (p = 0.006) and foot progression angle at mid-stance (p = 0.041) changed significantly from pre- to post-SDR. The variability of every temporal parameter was significantly reduced after SDR (p = 0.003-0.049), while it remained generally unchanged for the spatial parameters. Only a small change in gait velocity was observed, but variability in cadence was significantly reduced after SDR (p = 0.015). Almost all parameters changed with a tendency towards normal, but differences between TD and CP children remained in all parameters. DISCUSSION: The results confirm that SDR improves functional gait performance in children with CP. However, almost exclusively, parameters of temporal variability were significantly improved, leading to the conjecture that temporal variability and spatial variability may be governed independently by the motor cortex. As a result, temporal parameters of task performance may be more vulnerable to disruption, but also more responsive to treatment success of interventions such as SDR.http://europepmc.org/articles/PMC3724918?pdf=render |
| spellingShingle | Mustafa Sinan Bakir Franziska Gruschke William R Taylor Ernst Johannes Haberl Ilya Sharankou Carsten Perka Julia F Funk Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. PLoS ONE |
| title | Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. |
| title_full | Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. |
| title_fullStr | Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. |
| title_full_unstemmed | Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. |
| title_short | Temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy. |
| title_sort | temporal but not spatial variability during gait is reduced after selective dorsal rhizotomy in children with cerebral palsy |
| url | http://europepmc.org/articles/PMC3724918?pdf=render |
| work_keys_str_mv | AT mustafasinanbakir temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT franziskagruschke temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT williamrtaylor temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT ernstjohanneshaberl temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT ilyasharankou temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT carstenperka temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy AT juliaffunk temporalbutnotspatialvariabilityduringgaitisreducedafterselectivedorsalrhizotomyinchildrenwithcerebralpalsy |