Children with cerebral palsy commonly undergo invasive surgery to help improve their physical ability to move or walk. Unfortunately, there is no guarantee that these surgeries will work every time.
What if there was a way to predict whether or not a child with cerebral palsy will be able to benefit from invasive surgery? That's what researchers from the University of Washington and Gillette Children's Specialty Healthcare sought to address, developing a new quantitative method of assessing motor control called Dynamic Motor Control Index During Walking, or Walk-DMC.
"Only about 50 percent of children have significant improvement in their movement after these highly invasive surgeries. Our motivation has really been to figure out how we can push up these success rates," said Katherine Steele, a mechanical engineering assistant professor over at UW and one of the authors of the study.
Published in the journal Developmental Medicine & Child Neurology, the study showed that Walk-DMC scores prior to invasive surgery were associated with how much walking function and speed and gait improve after a patient undergoes the procedure.
In the past, doctors turned to subjective clinical measures to determine the motor control level of a patient with cerebral palsy. Walk-DMC, on the other hand, uses electromyography data, which monitors muscle activity through electrodes placed on the skin.
It's important to determine motor control because doctors have theorized that a patient with better brain-to-muscle connections before surgery is likely to do better after the procedure, as common surgical procedures focus on anatomical issues limiting movement but not how well muscles are controlled.
While there's still no standard way to quantify motor control, the researchers were able to develop algorithms that could turn motor control strategies from a patient into a single number, their Walk-DMC score.
They also found that while two children with cerebral palsy can walk similarly, they can have different Walk-DMC scores, suggesting that motor control can be independent of surgical outcomes. As such, the Walk-DMC score can help doctors in assessing what kind of treatment would be best for a cerebral palsy patient, whether they should undergo surgery or stick with more conservative methods of treatment.
The study, which Michael Schwartz and Adam Rozumalski are also part of, is still ongoing. It recently received a grant amounting to $1.5 million from the National Institute of Neurological Disorders and Stroke.
