Mirror visual feedback induces lower neuromuscular activity in children with spastic hemiparetic cerebral palsy |
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Authors: | Max G Feltham Annick Ledebt Frederik JA Deconinck Geert JP Savelsbergh |
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Institution: | 1. Motion Analysis Laboratory, Physical Medicine and Rehabilitation, University Hospital of Nantes, Nantes, France;2. Laboratory of Medical Information Processing (LaTIM), INSERM UMR 1101, Brest, France;3. Physical Medicine and Rehabilitation, University Hospital of Brest, Brest, France;4. Laboratory of Movement – Interactions – Performance (MIP), EA 4334, University of Nantes, Nantes, France;5. Pediatric rehabilitation center ESEAN, Nantes, France;6. Rehabilitation Engineering Chair Applied to Pediatrics (RECAP), Sainte-Justine University Hospital and Ecole Polytechnique de Montréal, Montréal, QC, Canada;7. Royal Children''s Hospital, Murdoch Children''s Research Institute, University of Melbourne, Melbourne, Australia |
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Abstract: | The study examined the effects of mirror feedback information on neuromuscular activation during bimanual coordination in eight children with spastic hemiparetic cerebral palsy (SHCP) and a matched control group. The ‘mirror box’ creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. The study incorporated two additional visual feedback conditions by placing a glass or opaque screen between the arms. During bilateral symmetric circular arm movements mirror visual feedback induced lower neuromuscular intensities in the shoulder muscles of the less impaired arm of children with SHCP compared to the other visual conditions. In addition, the mirror lead to shorter relative durations of eccentric and concentric activity in the elbow muscles of the more impaired arm, whereas no effects of visual feedback were found in a matched control group. These results suggest that replacing veridical visual information of the more impaired arm with a mirror reflection of the less impaired arm improves the motor control of children with SHCP during interlimb coupling. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to: (1) increase ipsilateral motor cortex excitability and (2) congruence between afferent (visual) feedback and the internal copy of the motor commands. |
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