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  • Title: Muscle fatigue during a short walking exercise in children with cerebral palsy who walk in a crouch gait.
    Author: Parent A, Pouliot-Laforte A, Dal Maso F, Cherni Y, Marois P, Ballaz L.
    Journal: Gait Posture; 2019 Jul; 72():22-27. PubMed ID: 31132593.
    Abstract:
    BACKGROUND: A deterioration of crouch gait was found in a group of children with cerebral palsy (CP) after a short walking exercise. The increased knee flexion reported after a continuous walk could be related with muscle fatigue and muscle strength. AIM: Does muscle fatigue appears at the end of a walking exercise in children with CP who walk in a crouch gait? METHODS: Eleven children with cerebral palsy (GMFCS I to III) who walk in a crouch gait were included. Isometric muscle strength was assessed using a handheld dynamometer. Children were asked to walk for 6 min at comfortable speed. Spatio-temporal, kinematic and electromyographic (EMG) measurements were recorded at the first and the last minute of the 6-minute walking exercise. Muscle fatigue was evaluated using the shift of EMG signals median frequency. RESULTS: There was no significant difference in walking speed, cadence, and step length at the end of the 6mwe. Maximal and mean anterior pelvic tilt decreased and knee flexion increased (p < 0.05). Rectus femoris EMG median frequency decreased (p < 0.05). The median frequency in other muscles did not decrease significantly. Greater hip extensor strength was associated with lesser knee flexion at the end of the 6-minute walking exercise (p < 0.05). SIGNIFICANCE: The increase in knee flexion at the end of the 6-minute walking exercise can be explained by muscle fatigue found in rectus femoris. Hip extensor strength can limit the deterioration of crouch gait after a 6-minute walking exercise representative of daily activities.
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