Today, many children who undergo an orthopedic surgery to treat cerebral palsy don’t see major improvements in their walking, or gait.
For parents and caregivers of Gillette patients who have diplegic cerebral palsy (cerebral palsy that affects the legs more than the arms), it makes the decision to pursue orthopedic surgery as a treatment option a difficult one.
Thanks to a five-year, $1.6 million Research Project Grant from the National Institutes of Health (NIH), teams from Gillette’s Center for Gait and Motion Analysis, in partnership with researchers at the University of Washington in Seattle, are working to make those treatment outcomes better.
“This grant allows us to open up new and exciting avenues of work”, says Michael Schwartz, director of bioengineering research at Gillette. “We can continue studying how motor control—the way we use our brain to activate and coordinate muscles—affects movement and treatment outcomes for those who have cerebral palsy.” Schwartz and team will also examine whether motor control changes after treatment.
Patients are now beginning to enroll in the study. The study will focus on 55 patients who have diplegic cerebral palsy and who will have surgery at Gillette. Each patient will undergo a gait analysis and an electromyogram (EMG) before and after the surgery to measure synergies (motor control).
Schwartz and the team measure motor control by calculating muscle synergies—muscle contractions activated together in fixed ratios. “For most people, walking typically uses between four and six synergies,” explains Michael. “But for people who have cerebral palsy, that number of walking synergies is often reduced.” Our brain activates and coordinates muscles by sending a series of complex signals, making it possible for us to do things like walk. Conditions like cerebral palsy, however, can impair these complex signals. In many cases, the impaired signals don’t allow muscles to modulate in a fluid manner, making walking difficult, if not impossible.
“The hope is that the data we collect will not only help surgeons provide better outcomes, but it will help Gillette patients and families make the best treatment decisions for them” says Michael.
The study is one of several that encompass Gillette’s ongoing gait and motion analysis research, which focuses on understanding the basic principles of movement, deciding on and improving treatment options for patients, and measuring outcomes.