Rectus femoris electromyography signal clustering: Data-driven management of crouch gait in patients with cerebral palsy.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Cerebral Palsy*/physiopathology ; Cerebral Palsy*/complications ; Electromyography*/methods ; Quadriceps Muscle*/physiopathology; Humans ; Male ; Female ; Child ; Cluster Analysis ; Retrospective Studies ; Gait/physiology ; Gait Disorders, Neurologic/physiopathology ; Gait Disorders, Neurologic/etiology ; Adolescent ; Child, Preschool ; Adult ; Gait Analysis/methods ; Young Adult

This study aimed to investigate how electromyography (EMG) cluster analysis of the rectus femoris (RF) could help to better interpret gait analysis in patients with cerebral palsy (CP). The retrospective gait data of CP patients were categorized into two groups: initial examination (E1, 881 patients) and subsequent examination (E2, 377 patients). Envelope-formatted EMG data of RF were collected. Using PCA and a combined PSO-K-means algorithm, main clusters were identified. Patients were further classified into crouch, jump, recurvatum, stiff and mild gait for detailed analysis. The clusters (labels) were characterized by a significant peak EMG activity during mid-swing (L1), prolonged EMG activity during stance (L2), and a peak EMG activity during loading response (L3). Notably, L2 contained 76% and 92% of all crouch patients at E1 and E2, respectively. Comparing patients with a crouch gait pattern in L2-E1 and L2-E2, two subgroups emerged: patients with persistent crouch (G1) and patients showing improvement at E2 (G2). The minimum activity of RF during 20-45% of the gait was significantly higher (p = 0.025) in G1 than in G2. A greater chance of improvement from crouch gait might be associated with lower RF activity during the stance phase. Using our findings, we could potentially establish an approach to improve clinical decision-making regarding treatment of patients with CP.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Davoudi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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Date Created: 20240820 Date Completed: 20240820 Latest Revision: 20240822

20240822

PMC11335125

10.1371/journal.pone.0298945

39163275