Pathological and Physiological Muscle Co-activation during Active Elbow Extension in Children with Unilateral Cerebral Palsy

Publication date: Available online 29 October 2016
Source:Clinical Neurophysiology
Author(s): A. Sarcher, M. Raison, F. Leboeuf, B. Perrouin-Verbe, S. Brochard, R. Gross
[Objective]To address the roles and mechanisms of co-activation in two flexor/extensor pairs during elbow extension in children with cerebral palsy (CP).[Methods]13 typically developing (TD) and 13 children with unilateral spastic CP performed elbow extension/flexion at different speeds. Elbow angle and velocity were recorded using a 3D motion analysis system. The acceleration and deceleration phases of extension were analyzed. Co-activation of the brachioradialis/triceps and biceps/triceps pairs was computed for each phase from surface electromyographic signals. Statistical analysis involved linear mixed effects models and Spearman rank correlations.[Results]During the acceleration phase, there was strong co-activation in both muscle pairs in the children with CP, which increased with speed. Co-activation was weak in the TD children and it was not speed-dependent. During the deceleration phase, co-activation was strong and increased with speed in both groups; co-activation of brachioradialis/triceps was stronger in children with CP, and was negatively correlated with extension range and positively correlated with flexor spasticity.[Conclusions]Abnormal patterns of co-activation in children with CP were found throughout the entire movement. Co-activation was specific to the movement phase and to each flexor muscle.[Significance]Co-activation in children with CP is both physiological and pathological.



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