Assessment Tool for Cerebral Palsy May Help Determine if Surgery of Benefit to a Child

Researchers have developed a new quantitative way of assessing motor control in children with cerebral palsy. The method, called the Dynamic Motor Control Index During Walking (Walk-DMC), may be useful in improving dynamic motor control, which is associated with better clinical outcomes, and for predicting the likely benefit of aggressive treatments such as surgery.

The study, “Dynamic motor control is associated with treatment outcomes for children with cerebral palsy,” was published in the journal Development Medicine & Child Neurology.

It has been theorized that patients with better motor control before surgery have improved outcomes following the procedure, but no standardized test objectively quantifies motor control in people with cerebral palsy.

Researchers at the Gillette Children’s Specialty Healthcare and the University of Washington had previously observed that children with cerebral palsy use motor control strategies similar to those of adults who have had a stroke. So to measure motor control, they developed an algorithm that translates the strategies of a patient’s motor control into a number representing its Walk-DMC. The assessment tool relies on electromyography data, which uses electrodes to monitor muscle activity.

In this study, researchers used the algorithm to evaluate 473 ambulatory children with cerebral palsy who underwent surgery.

Results indicated that children with higher Walk-DMC scores prior to surgery had better treatment outcomes. “Two individuals can walk similarly, but have different motor control strategies. These results suggest that motor control is uniquely and independently associated with outcomes and can help us decide when you might recommend surgery and when you might be more conservative in treatment,” Dr. Katherine Steele, a study author, said in a news release.

Future research plans include analyzing if motor control changes after treatment, and the development of options for children who are less likely to benefit from surgery.

“The kids with good motor control are likely to get better once you fix their musculoskeletal issues, because they have the capacity to control their muscle groups and limbs,” Dr. Steele said. “The big question is: What can we do for the other kids? If muscle control can change, that opens the door for more rehabilitation options. And if it cannot, that is good to know so we can help optimize their movement and quality of life.”