Walk-DMC Assessment Seeks to Predict Surgical Outcomes for Kids with CP

A new quantitative assessment system created by University of Washington researchers could help predict which children with cerebral palsy (CP) are most likely to benefit from surgeries intended to improve their mobility.

A research team from University of Washington’s Department of Mechanical Engineering and Gillette Children’s Specialty Healthcare based their Walk-DMC system on electromyography (EMG) data, according to a University of Washington news announcement. EMG monitors a patient’s muscle activity via electrodes on the skin.

In a study published in April in Developmental Medicine & Child Neurology, the research team announced that patients’ Walk-DMC scores were “significantly linked with how much the patient’s gait, walking speed and function improved after surgery.”

Many children with CP undergo surgeries that lengthen tendons, rotate bones and transfer muscles to different locations to try to improve their mobility.

Kat Steele, an assistant professor of mechanical engineering at the University of Washington, said of the research, “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.”

The team noted that brain injuries vary widely, and that as a result, children with CP respond in different ways to treatments.

“Doctors had theorized that patients with better motor control — the brain-to-muscle connections that allow someone to coordinate movement — prior to surgery were likely to fare better after surgical interventions,” the announcement said. “Common surgeries for individuals with CP typically fix musculoskeletal or anatomical issues that limit physical movement, but don’t necessarily address how well a patient can control those muscles.”

Steele and her colleagues had previously done research on motor control in children with CP and determined that children with CP employed motor control strategies that are less complex than those used by children without CP. The researchers theorized that these different motor control strategies led to mobility difficulties for children with CP, and they created algorithms that could assign a number to a patient’s motor control strategy.

The team referred to that number as a patient’s Dynamic Motor Control Index During Walking, also known as Walk-DMC.

Steele said future studies would look at developing other options for children with CP who, according to their Walk-DMC scores, are less likely to benefit significantly from surgery.

The research is being funded by the National Institute of Neurological Disorders & Stroke.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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