The “Muscle synergies” project promoted by the Ariel Foundation and Cnr aims to study movement in children affected by this condition in order to offer personalized treatments
What do the algorithms, a gait analysis laboratory equipped with the most advanced devices e Arielthe brightest of Uranus’ 27 moons? These are the three main ingredients of “Muscle synergies”
, a scientific study that aims to “improve the care and assistance of small patients affected by neuromotor disabilities through the observation of the differences in muscle synergies during walking in children with pathology and in healthy ones”. To explain it is the professor Nicola Portinarohead of the Pediatric and Neuro-orthopedics Operating Unit of the Humanitas Research Hospital and scientific director of the Ariel Foundation.
The first ingredient: the Ariel Foundation
Here is the first of the ingredients. Ariel is the name of the Foundation founded in 2003 to support families with children suffering from infantile cerebral palsy and other neuromotor disabilities: spina bifida, Arnold Chiari syndrome, SMA (spinal muscular atrophy), muscular dystrophy (also in the Duchenne and Becker variants) and Dandy Walker syndrome. Infantile cerebral palsy is the most common neuromotor disease in children. Due to irreversible but non-progressive damage to the central nervous system for different causes (such as haemorrhage or ischemia), it includes a group of disorders that cause motor problems. The manifestations of the disease, however, are not fixed, because the symptoms change over time and can benefit from rehabilitation or, in severe cases, surgical treatment.
The second ingredient: the laboratory
The laboratory In eighteen years of activity, the Ariel Foundation has managed to collect q
thatthe half million euros, then invested in research. «The funds were primarily dedicated to construction of a gait analysis laboratory equipped with the most advanced machinery, such as a baropodometric platform, eight infrared cameras, electromyograph (a device that allows you to examine nerve, motor and sensory conduction and to evaluate muscle activity during voluntary activation and at rest, ed) of wireless surface and 16 surface electrodes », adds Professor Portinaro. We have therefore arrived at the second ingredient of the “Muscle Synergies” project created in collaboration with the STIIMA Institute of the National Research Center.
What are muscle synergies
Let’s try to understand better what it is. «The concept of muscle synergies is based on the hypothesis that the central nervous system, to better coordinate movement, does not activate the muscles individually but instead gives rise to groups of muscles that help each other to perform similar activities. This does not happen in children with neuromotor disabilities ». “In the laboratory, studying the kinetics and kinematics, that is, the movements and forces produced during normal walking and not instead produced in the pathological path, we will be able to highlight the muscular synergies that the nervous system activates to coordinate movement, to obtain standard reference models to be compared with the synergistic activations found in patients with neuromotor disorders of the musculoskeletal system. The ultimate goal is obtain a new tool to help the child manage their pathology, exploiting his muscular co-activations and planning a possible personalized surgery that can allow him the best post-operative recovery, physiotherapy and rehabilitation ».
The project restarts after the “block” from Covid
Part of the research, which had to stop during the worst stages of the Covid pandemic and has now started again, has focused on movements of the upper limbs, linking to analysis of the parietal and premotor brain circuits of control. “To reach, grasp and manipulate objects, our central nervous system must be able to model musculoskeletal activity in order to make the movement efficient and congruent to the context and to the type of object to be handled », he says Luca Fornia, researcher at the Department of Medical Biotechnology and Translational Medicine of the University of Milan. “For this purpose it is important understand how the muscular synergies of the arm and hand coordinate to perform the movement. Understanding the variations, the deviations that can coexist in specific patient populations, also in the light of a mechanism of environmental plasticity and adaptation, are important elements to study as a greater knowledge of these mechanisms can lead to development of alternative and hopefully more effective neurorehabilitation techniques».
Path analysis
The study then took into consideration the muscle synergies activated during the walk, a part that two trainees worked on, the doctors Benedetta Lepore and Giulia Beltrame. «Not much is known about the muscular synergies of children and adolescents and how these vary with varying speed. Therefore we decided to studying muscle synergies in a group of adolescents. To understand which muscles are simultaneously involved in walking, each child is subjected to a careful analysis of the gait he collects kinetic-kinematic data and electromyographic signals from the eight muscles under study. We currently have analyzed the walk of 20 healthy children aged between 10 and 14 years for which the creation of standard electromyographic curves of synergies is in progress and, in parallel, the journey of 10 children with hemiplegia (paralysis of one of the two parts of the body), obtaining a database of standard reference synergies that will subsequently be compared to the synergistic activations of patients suffering from infantile cerebral palsy “, says Lepore.
The third ingredient: algorithms
Giulia Beltrameon the other hand, he analyzed another aspect and that is chow the muscle activation changes as the walking speed varies. “Five boys were included in the study, all clinically healthy from a neuro-orthopedic point of view. They were asked to walk at two different speeds, while the surface electromyograph recorded the muscle activation of eight muscles in each lower limb. The electromyographic signal was subsequently processed by software that allowed the application of an algorithm mathematical, necessary for the extraction of muscle synergies “. Algorithms, the third ingredient of the project.
New patients are sought
To validate the results obtained, it is now necessary to expand the study sample. In 2022, the path analysis activity will restart in particular of children with neuromotor disabilities. Because of this, Ariel Foundation launches an enrollment campaign aimed at children aged 8 to 14 with spastic diplegiawho have never undergone interventions. For information, write to [email protected].
Fundraising
«Muscle synergies» enters its new phase. To support it, one has been activated crowdfunding campaign on the Rete delDono platform (here the direct link to the page) to which everyone can contribute. «With the donations collected a new research grant will be activated for a physiotherapist that in the first six months of 2022 it will proceed with the selection and enrollment of patients with disabilities and the first recording of movement parameters. To support Ariel’s research, just go to the Rete del Dono platform and search for the Ariel Foundation. The Continuous Muscle Synergy Search will appear! I think this will become a tool to fulfill our great desire to improve the quality of life of an increasing number of children with neuromotor disabilities, together with their families ”, underlines Professor Portinaro.
March 1, 2022 (change March 1, 2022 | 09:39)
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