فعالیت الکتریکی عضلات اندام تحتانی و تنه هنگام راه رفتن با و بدون تکلیف دوگانه شناختی در بیماران مبتلا به فلج مغزی و افراد سالم

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری بیومکانیک ورزشی، استادیار، دانشگاه تبریز (نویسندۀ مسئول)

2 کارشناسی ارشد کنترل حرکتی، دانشگاه تبریز

چکیده

اجرای تکلیف دوگانه باعث کاهش تعادل و اختلال در گام‌برداری فرد می‌شود. اما اثر این نوع تکلیف بر فعالیت الکتریکی عضلات افراد مبتلا به فلج مغزی ناشناخته است. از این ‌رو هدف از مطالعۀ حاضر بررسی فعالیت الکترومیوگرافی عضلات اندام تحتانی و تنۀ بیماران مبتلا به فلج مغزی و افراد سالم هنگام راه رفتن عادی و راه رفتن با تکلیف دوگانۀ شناختی بود. به این منظور با استفاده از دستگاه الکترومیوگرافی USB2+ EMG و الکترودهای سطحی دوقطبی، شدت فعالیت عضلات راست‌کنندۀ ستون مهره‌ای کمری (ES)، راست‌رانی (RF) و دوسر رانی (BF)  10 بیمار مبتلا به فلج مغزی و 10 نفر آزمودنی سالم همگن هنگام راه رفتن با و بدون تکلیف دوگانۀ شناختی ثبت شد. داده‌های به‌دست‌آمده با نرم‌افزار 22SPSS و روش‌های آماری ANOVA ویژۀ داده‌های تکراری در سطح معناداری 05/0 تجزیه‌وتحلیل شدند. نتایج نشان داد هنگام راه رفتن با وظیفۀ شناختی دوگانه، شدت فعالیت عضلات L3، BF و RF سمت چپ و عضلۀ L3 و BF سمت راست بیماران فلج مغزی به‌طور معناداری بیشتر از افراد سالم بود. الگوی تغییر شدت فعالیت الکتریکی همسان‌سازی شدۀ عضلات L3، BF و RF در هنگام راه رفتن عادی و راه رفتن با تکلیف دوگانۀ شناختی در دو گروه سالم و CP متفاوت بود و بین سه عامل گروه، عضله و وظیفۀ حرکتی تأثیر متقابل معناداری مشاهده شد. بر اساس نتایج، وظیفۀ دوگانۀ شناختی فعالیت عضلات L3 و BF افراد فلج مغزی را بیشتر از افراد سالم افزایش می‌دهد که این افزایش می‌تواند به تلاش فرد برای حفظ وضعیت بدن و تعادل پویا در آن‌ها نسبت داده شود. بنابراین توجه به تکلیف دوگانه در ارزیابی و طراحی برنامه‌های تمرینی ویژۀ افراد فلج مغزی توصیه می‌شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Electromyography Activity of Lower Limb and Erector Spinae Muscles During Walking with and Without Cognitive Dual Task in Patients with Cerebral Palsy and Healthy Controls

نویسندگان [English]

  • shirin YAZDANI 1
  • mobarake Elhami 2
2 department of motor behaviour, faculty of physical education and sport science, university of Tabriz, Tabriz, Iran
چکیده [English]

Performing dual task may impair balance and gait in cerebral palsy (CP). But the effect of dual task on the electromyographic activity of CP patients has not been well studied yet. The aim of this study was to investigate the electromyography (EMG) activity of the lower limbs and erector spinae muscles in CP patients and healthy controls during walking with and without a cognitive dual task. To do so, the EMG activity of biceps femoris (BF), rectus femoris (RF) and erector spinae at L3 level (L3) muscles of 10 CP patients and 10 healthy controls were recorded using an EMG USB2+ system and bipolar electrodes during walking with and without the cognitive task. Data were statistically analyzed using SPSS 22 and ANOVA for repeated measures with a significance level of 0.05. Results showed that during walking with the cognitive dual task, the EMG activity of the left L3, BF and RF muscles and right L3 and BF muscles was significantly higher than that of the normal subjects. The pattern of normalized EMG activity of L3, BF and RF muscles of CP patients and healthy control subjects differed during gait with and without the cognitive dual task, and there was a significant interaction between the group, muscle and task factors. Based on our results, cognitive dual task increases EMG activity of CP patients more than healthy subjects. This increase can be attributed to the effort of CP patients to [1]maintain posture and dynamic balance. Thus, it is recommended to pay attention to the cognitive dual task when evaluating and designing exercise programs for CP people with cerebral palsy.
 

کلیدواژه‌ها [English]

  • cerebral palsy
  • cognitive dual task
  • Gait
  • Electromyography
  1. Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta‐ Developmental Medicine & Child Neurology. 2013 Jun;55(6):509-19.
  2. Krigger WK. Cerebral palsy: An over view. American family physican journal volume. 2006. 73. Number 1. January 1.
  3. Hughes JE. Special Physical Education, Adapted, Corrective, Developmental 3rd ed. 1972
  4. Dobson F, Morris ME, Baker R, Graham HK. Unilateral cerebral palsy: a population‐based study of gait and motor function. Developmental Medicine & Child Neurology. 2011 May;53(5):429-35.
  5. Yu Y, Chen X, Cao S, Wu D, Zhang X, Chen X. Gait synergetic neuromuscular control in children with cerebral palsy at different gross motor function classification system levels. Journal of neurophysiology. 2019 May 1;121(5):1680-91.
  6. Noble JJ, Gough M, Shortland AP. Selective motor control and gross motor function in bilateral spastic cerebral palsy. Developmental Medicine & Child Neurology. 2019 Jan;61(1):57-61.
  7. Villarrasa-Sapiña I, Estevan I, Gonzalez LM, Marco-Ahulló A, García-Massó X. Dual task cost in balance control and stability in children from 4–7 years old. Early Child Development and Care. 2019 Mar 11. 190(16): 2533-2542
  8. Parent A, Pouliot-Laforte A, Dal Maso F, Cherni Y, Marois P, Ballaz L. Muscle fatigue during a short walking exercise in children with cerebral palsy who walk in a crouch gait. Gait & posture. 2019 Jul 1; 72:22-7.
  9. Tedroff K, Gyllensvärd M, Löwing K. Prevalence, identification, and interference of pain in young children with cerebral palsy: a population-based study. Disability and rehabilitation. 2019 Sep 16:1-7.
  10. Noori, J., Seif Naraghi A., and Ashayeri H. The effect of sensory integration intervention on the fine finger skills improvement in 8 to 12 years old children with cerebral palsy. 2019. 105. 21-31. (In Persian)
  11. Böhm H, Döderlein L. Gait asymmetries in children with cerebral palsy: do they deteriorate with running? Gait & posture. 2012 Feb 1;35(2):322-7.
  12. Carcreff L, Bonnefoy-Mazure A, Valenza N, Allali G, Fluss J, Armand S. Influence of cognitive-motor interference on gait spatiotemporal parameters in children and adolescents with cerebral palsy: A preliminary study؛ Gait & Posture. 2016,49, 17.
  13. Riad J, Haglund-Akerlind Y, Miller F. Classification of spastic hemiplegic cerebral palsy in children. Journal of Pediatric Orthopaedics. 2007 Oct 1;27(7):758-64.
  14. Bruijn SM, Millard M, Van Gestel L, Meyns P, Jonkers I, Desloovere K. Gait stability in children with Cerebral Palsy. Research in developmental disabilities. 2013 May 1;34(5):1689-99.
  15. Haakana P, Nurminen J, Kulmala JP, Niemelä T, Marttinen Rossi E, Mäenpää H, Piitulainen H. Effects of cognitive and motor dual-task on spatiotemporal gait parameters in children and adolescents with Cerebral Palsy. Gait and Posture. 2020;81(Suppl 1). 130-131.
  16. Papageorgiou E, Simon-Martinez C, Molenaers G, Ortibus E, Van Campenhout A, Desloovere K. Are spasticity, weakness, selectivity, and passive range of motion related to gait deviations in children with spastic cerebral palsy? A statistical parametric mapping study. PloS one. 2019 Oct 11;14(10): e0223363.
  17. Nashner LM, Shumway-Cook A, Marin O. Stance posture control in select groups of children with cerebral palsy: deficits in sensory organization and muscular coordination. Experimental brain research. 1983 Mar 1;49(3):393-409.
  18. Ya-Ching H. Influence of accuracy constraints on bimanual coordination and gait performance in children with unilateral spastic cerebral palsy. Gait & posture. 2019 Feb 1; 68:106-10.
  19. Katz-Leurer M, Rotem H, Meyer S. Effect of concurrent cognitive tasks on temporo-spatial parameters of gait among children with cerebral palsy and typically developed controls. Developmental neurorehabilitation. 2014 Dec 1;17(6):363-7.
  20. Lima CR, Pavão SL, de Campos AC, Rocha NA. Impact of dual task on postural sway during sit-to-stand movement in children with unilateral cerebral palsy. Clinical Biomechanics. 2020 Aug 1; 78:105072.
  21. Kahya M, Moon S, Ranchet M, Vukas RR, Lyons KE, Pahwa R, Akinwuntan A, Devos H. Brain activity during dual task gait and balance in aging and age-related neurodegenerative conditions: a systematic review. Experimental gerontology. 2019 Dec 1; 128:110756.
  22. Fino PC, Parrington L, Pitt W, Martini DN, Chesnutt JC, Chou LS, King LA. Detecting gait abnormalities after concussion or mild traumatic brain injury: a systematic review of single-task, dual-task, and complex gait. Gait & posture. 2018 May 1; 62:157-66.
  23. Tomas-Carus P, Biehl-Printes C, Pereira C, Veiga G, Costa A, Collado-Mateo D. Dual task performance and history of falls in community-dwelling older adults. Experimental gerontology. 2019 Jun 1; 120:35-9.
  24. Morgan PE, McGinley JL. Falls, fear of falling and falls risk in adults with cerebral palsy: A pilot observational study. The European Journal of Physiotherapy. 2013 Jun 1;15(2):93-100.
  25. Reilly DS, Woollacott MH, van Donkelaar P, Saavedra S. The interaction between executive attention and postural control in dual-task conditions: children with cerebral palsy. Archives of physical medicine and rehabilitation. 2008 May 1;89(5):834-42.

 

  1. Kahneman D. Attention and effort. Englewood Cliffs, NJ: Prentice-Hall; 1973 Mar.
  2. De Sèze MP, Cazalets JR. Anatomical optimization of skin electrode placement to record electromyographic activity of erector spinae muscles. Surgical and Radiologic Anatomy. 2008 Mar 1;30(2):137-43.
  3. Maffiuletti NA, Lepers R. Quadriceps femoris torque and EMG activity in seated versus supine position. Medicine & Science in Sports & Exercise. 2003 Sep 1;35(9):1511-6.
  4. Shayesteh M, Farahpour N, Jafarnezhadgero A. Comparisons of The Effects of Squat and Leg ‌Press Exercises on The EMG Activity of Quadriceps Femoris Muscles During Step Descending Activity. Journal of Applied Exercise Physiology. 2019 Jun 22;15(29):143-54. (In Persian)
  5. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of electromyography and Kinesiology. 2000 Oct 1;10(5):361-74.
  6. Stackhouse SK, Binder‐Macleod SA, Lee SC. Voluntary muscle activation, contractile properties, and fatigability in children with and without cerebral palsy. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2005 May;31(5):594-601.
  7. Konrad P. The abc of emg. A practical introduction to kinesiological electromyography. 2005 Apr;1(2005):30-5.
  8. Schmid AB, Dyer L, Böni T, Held U, Brunner F. Paraspinal muscle activity during symmetrical and asymmetrical weight training in idiopathic scoliosis. Journal of Sport Rehabilitation. 2010 Aug 1;19(3):315-27.
  9. Adjenti SK, Louw G, Jelsma J, Unger M. An electromyographic study of abdominal muscle activity in children with spastic cerebral palsy. The South African journal of physiotherapy. 2017;73(1): 1-7.
  10. Yazdani sh, Elhami M. Effect of motor dual task on the electromyography of lower limb and trunk muscles during gait in cerebral palsy and healthy subjects. Studies in Medical Sciences. 2021 Jan 10;31(11):836-46. (In Persian)
  11. Di Nardo F, Spinsante S, Pagliuca C, Poli A, Strazza A, Agostini V, Knaflitz M, Fioretti S. Variability of Muscular Recruitment in Hemiplegic Walking Assessed by EMG Analysis. Electronics. 2020 Oct;9(10):1572.
  12. Gharib NM, Abd-El Maksoud GM, Eldin S, Elsayed B. Efficacy of concurrent cognitive-motor training on gait in hemiparetic cerebral palsy: a randomized controlled trial. Int J Physiother Res. 2017;5(1):1852-62. (In Persian)
  13. Winters TF, Gage JR, Hicks R. Gait patterns in spastic hemiplegia in children and young adults. J Bone Joint Surg Am. 1987 Mar 1;69(3):437-41.
  14. Farsi A, Bagherzade F, Sheykh M, Tejari F. The effect of dual task on balance and electrical activity of selected muscles of male students 18 to 30 years of University of Tehran. Movement journal. 2010 May,12, 39; 49-64. (In persian)
  15. Sharifmoradi K., Farahpour N. kinematic, kinetic and electromyographic analysis of gait in Parkinson disease with emphasis on cognitive task and visual attention. 2015. Phd thesis. (In Persian)

 

 Roostaei M, Raji P, Morone G, Razi B, Khademi-Kalantari K. The effect of dual task conditions on gait and balance performance in children with cerebral palsy: a systematic review and meta-analysis of observational studies. Journal of Bodywork and Movement Therapies. 2021 April. 26: 448-462.