Influence of surgical intervention on pre- and post-surgery patient specific muscle synergies in children with cerebral palsy

Abstract

Muscle synergy analysis has been explored as means to better understand changes in motor control, with the aim to improve treatment outcomes after Single Event Multilevel Surgery (SEMLS) for children with cerebral palsy (CP). In this single-group study, we assess changes between pre- and post-surgery muscle synergies at both patient specific, and cohort levels after surgical intervention for children with CP. We analysed the walking data of 11 patients between the ages of 7–18 years old, including surface electromyography, joint angles and ground reaction forces, recorded before and after surgery. Muscle synergies were extracted and assessed for changes in dimensionality and sparseness between pre- and post-surgery. Our results show that at a patient specific level, pre- and post-surgery muscle synergies were not highly similar, with only 41% of paired synergies showing high correlation ( $$r$$ $$>$$ 0.8) after surgery, and an overall mean correlation of 0.53 $$\pm$$ 0.25. On the other hand, synergies obtained at the cohort level were highly similar post-surgery ( $$r$$ $$>$$ 0.87). These findings suggest that at an individual level, pre-surgery motor control cannot be assumed to be preserved post-surgery. CP synergies obtained at the cohort level from pre-surgery data can demonstrate more reliable preservation in post-surgery motor control. We also observed sparseness increasing with the number of synergies, which provides an interesting future research direction exploring the link with more complex motor control and a more typical gait pattern.

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