In Hereditary Spastic Paraplegia (HSP) type 4 (SPG4) a length-dependent axonal degeneration in the cortico-spinal tract leads to progressing symptoms of hyperreflexia, muscle weakness, and spasticity of lower extremities. Even before the manifestation of spastic gait, in the prodromal phase, axonal degeneration leads to subtle gait changes. These gait changes - depicted by digital gait recording - are related to disease severity in prodromal and early-to-moderate manifest SPG4 participants.We hypothesize that dysfunctional neuro-muscular mechanisms such as hyperreflexia and muscle weakness explain these disease severity-related gait changes of prodromal and early-to-moderate manifest SPG4 participants. We test our hypothesis in computer simulation with a neuro-muscular model of human walking. We introduce neuro-muscular dysfunction by gradually increasing sensory-motor reflex sensitivity based on increased velocity feedback and gradually increasing muscle weakness by reducing maximum isometric force.By increasing hyperreflexia of plantarflexor and dorsiflexor muscles, we found gradual muscular and kinematic changes in neuro-musculoskeletal simulations that are comparable to subtle gait changes found in prodromal SPG4 participants.Predicting kinematic changes of prodromal and early-to-moderate manifest SPG4 participants by gradual alterations of sensory-motor reflex sensitivity allows us to link gait as a directly accessible performance marker to emerging neuro-muscular changes for early therapeutic interventions.


    Access

    Download


    Export, share and cite



    Title :

    Dysfunctional neuro-muscular mechanisms explain gradual gait changes in prodromal spastic paraplegia.


    Contributors:

    Publication date :

    2023-01-01


    Remarks:

    Journal of neuroEngineering and rehabilitation 20(1), 90 (2023). doi:10.1186/s12984-023-01206-8


    Type of media :

    Article (Journal)


    Type of material :

    Electronic Resource


    Language :

    English



    Classification :

    DDC:    629



    Mobile digital gait analysis objectively measures progression in hereditary spastic paraplegia

    Loris, Evelyn / Ollenschläger, Malte / Greinwalder, Teresa et al. | Wiley | 2023

    Free access

    Kinetic gait patterns in hemiplegia in spastic cerebral palsy

    Hullin, MG / Robb, JE / Loudon, IR | Elsevier | 1994


    Effects of quadriceps strengthening on crouch gait in children with spastic diplegia

    PhD PT Damiano, Diane / PhD Kelly, Luke / PhD Vaughan, Christopher | Elsevier | 1994


    Spastic Extension Splint

    G. J. Thorpe / T. J. Bushey / R. P. Plumb et al. | NTIS | 1966


    Gait parameters in children with bilateral spastic cerebral palsy: a systematic review of randomized controlled trials

    Gómez Pérez, Cristina / Font Llagunes, Josep Maria / Martori, Joan Carles et al. | BASE | 2018

    Free access