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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2016 April;52(2):176-85


language: English

Assessment of selective motor control in clinical Gillette’s test using electromyography

Faustyna MANIKOWSKA 1, Brian P. J. CHEN 1, Marek JÓŹWIAK 1, Maria K. LEBIEDOWSKA 2

1 Department of Pediatric Orthopedics and Traumatology, Poznań University of Medical Sciences, Poznań, Poland; 2 Faculty of Physics, Adam Mickiewicz University, Poznań, Poland


BACKGROUND: Selective motor control (SMC), the ability to isolate selected muscle activation during a functional task, is often impaired. Gillette’s SMC scale is commonly used to classify the impairment level; however it may not be sensitive to muscle coactivation.
AIM: To characterize differences in muscle activation levels and coactivation incidence in Gillette’s SMC grade levels.
DESIGN: Non-randomized observational study.
SETTING: Participants were recruited and examined in the motion analysis laboratory of a university hospital.
POPULATION: Forty-two participants were enrolled: 23 patients with CP (13 females, 10 males; 15±5.59 years, range: 7-28 years; bilateral involvement; GMFCS levels I to III) and 19 able-bodied volunteers (14 females, 5 males; 22±1.54 years, range: 20-24 years).
METHODS: Participants flexed each knee three times at self-paced velocity. Each limb was classified into one of three types using Gillette’s SMC scale: Type 0 (CP limbs with no ability to isolate movement), Type 2 (CP limbs with complete isolation of movement) and Type C (Control limbs of able-bodied volunteers). Surface electromyography recorded muscle activation levels of hamstring, rectus femoris, hip adductor, gastrocnemius and tibialis anterior muscles. We applied the Friedman ANOVA χ2 Test to analyze muscle co-activation incidence and Kruskal-Wallis ANOVA and Median Tests to analyze muscle activation levels. We used the Wilcoxon Matched-Pairs Test to compare results between SMC Types.
RESULTS: Comparing mean activation levels of the majority of muscles, we found: CP limbs (Type 0+2) > Control limbs (P<0.001); Type 0 > Type 2 (P<0.05); and Type 2 > Type C (P<0.01). The incidence of muscle co-activation was affected by CP (P=0.008) and differed by SMC type (P<0.001).
CONCLUSIONS: Our quantitative study confirmed that SMC is worse in Gillette’s Type 0 limbs than in Type 2 limbs. We also found that the SMC of Type 2 limbs of CP patients in CP patents is not equivalent to that of Type 2 limbs in able-bodied volunteers.
CLINICAL REHABILITATION IMPACT: A better characterization of this clinical test will help gauge its usefulness in evaluating the effectiveness of rehabilitation treatments.

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