The Decline in Walking Performance in Adults With Cerebral Palsy - Influence of Performance Fatigability

Centre Hospitalier Universitaire de Saint Etienne30 enrolled

Overview

Due to an early brain injury occurring in antenatal or postnatal, cerebral palsy (CP) causes alteration in motor function with posture and gait disorders. It is commonly observed motor performance degradation during adulthood, and the underlying pathophysiology remains poorly known.

One of the hypotheses to explain the decline in walking capacities in adults with CP is their greater fatigability, that could be related to energy overconsumption (due to the specific biomechanical constraints of their walking pattern) and/or the occurrence of early sarcopenia affecting the compensatory muscle mechanisms commonly seen in children to compensate for architectural disorders and posture alterations. To optimize prevention and/or therapy in these patients, it is crucial to better understand the aetiology of fatigability and its role in the decline in walking performance.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Muscle Spasticity Paralysis; Cerebral

Interventions

Fatigability assessmentOTHER

An isometric dynamometer will be used to assess fatigability development during a task to failure. Throughout the task, which consists of blocks of 3 minutes, neuromuscular assessments will take place to determine the evolution of fatigability and its peripheral and central determinants.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Common for CP and healthy volunteers: * Capable of walking for six minutes without stopping * Capable of consenting to the tests Specific for the CP group * GMFCS I or II at age 18 * Spastic diplegic cerebral palsy Exclusion Criteria: * Counter-indications to the test procedures * Mental retardation or intelligence quotient (IQ) below 80 * Accompanying diseases not allowing for the test setup * Major surgeries altering performance in the last six months * Injection of botulin altering maximal force production in the last three months * Refusing to sign the consent form

Locations (1)

Centre Hospitalier de Saint-Etienne

Saint-Etienne, France

Outcomes

Primary Outcomes

Neuromuscular fatigue

Neuromuscular fatigue, defined as the decrease in maximal voluntary force (in % of the resting value) developed in isometric knee extension following a standardized fatigue protocol.

Time frame: Week : 6

Secondary Outcomes

Maximum voluntary force torque measurement of the knee flexor muscles

Measurement of the (in Nm) of the knee flexor muscles in isometric and dynamic contraction.

Time frame: Week : 2

Maximum voluntary force torque measurement of the plantar flexor

Measurement of the (in Nm) of the plantar flexor in isometric and dynamic contraction.

Time frame: Week : 2

Maximum voluntary force torque measurement of knee extensor muscles

Measurement of the (in Nm) of the knee extensor muscles in isometric and dynamic contraction.

Time frame: Week : 4

Level of voluntary activation measurement

Measurement of the level of voluntary activation (in %) determined by the force increment obtained following electrical stimulation of the motor nerve during a muscle condition of maximum contraction.

Time frame: Week : 6

Measurement of joint amplitude (in °)

Evaluation of the passive muscular properties of the dominant leg, on the knee flexor muscles, and on the plantar flexor and knee extensor muscles

Time frame: Week : 6

Measurement of passive torque (in Nm)

Evaluation of the passive muscular properties of the dominant leg, on the knee flexor muscles, and on the plantar flexor and knee extensor muscles

Data from ClinicalTrials.gov

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