Evidence map›Paper›PMID 39920813›Full record

ArticleJournal of neuroengineering and rehabilitation2025

Can muscle synergies shed light on the mechanisms underlying motor gains in response to robot-assisted gait training in children with cerebral palsy?

Gloria P Vergara-Diaz, Stefano Sapienza, Jean-François Daneault, Eric Fabara, Catherine Adans-Dester, Giacomo Severini, Vincent C K Cheung, Carmen Echevarría Ruiz de Vargas, Donna Nimec, Paolo Bonato

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In one paragraph

Article in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Gloria P Vergara-DiazDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
Stefano SapienzaDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
Jean-François DaneaultDepartment of Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, USA.
Eric FabaraDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
Catherine Adans-DesterDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
Giacomo SeveriniSchool of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland.
Vincent C K CheungSchool of Biomedical Sciences, and The Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong, China.
Carmen Echevarría Ruiz de VargasDepartment of Physical Medicine and Rehabilitation, Hospital Universitario Virgen del Rocío, Seville, Spain.
Donna NimecDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
Paolo BonatoDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA. pbonato@mgh.harvard.edu.

Funding

Fundación Alfonso Martín Escudero FellowshipReal Colegio Complutense at Harvard (RCC) Fellowship
6 · The paper itself

Abstract

backgroundChildren with cerebral palsy (CP) often experience gait impairments. Robot-assisted gait training (RGT) has been shown to have beneficial effects in this patient population. However, clinical outcomes of RGT vary substantially from patient to patient. This study explored the hypothesis that clinical outcomes are associated with changes in muscle synergies in response to RGT.

methodsThirteen children with CP and Gross Motor Function Classification Scale (GMFCS) levels I-IV were recruited in the study. Children participated in a 6 week-RGT intervention and underwent clinical evaluations and gait studies-with focus on the analysis of electromyographic (EMG) data-pre- and post-training. Lower-limb muscle synergies were derived from the EMG recordings. Pre- vs. post-RGT clinical outcomes and muscle synergies were compared to explore potential relationships.

resultsThree and, less often, two muscle synergies were detected in study participants pre-RGT. Linear mixed effect models showed that composition of the muscle synergies and their temporal activation coefficients present deviations from normative data proportional to the severity of functional limitations (i.e., GMFCS levels, p < 0.01). At a group level, changes in muscle synergies pre- vs. post-RGT did not significantly correlate with changes in clinical outcomes (p > 0.05). However, it was observed that participants who displayed prominent changes in muscle synergies also displayed large improvements in clinical scores.

conclusionsGait impairments in children with CP were associated with muscle synergies that deviated from normative. Participants who demonstrated the most substantial improvements in clinical scores following RGT exhibited multiple changes in the muscle synergies. However, no statistically significant correlations were identified at the group level. Future studies relying on larger datasets are needed to further investigate this observation and potential underlying mechanisms.

Indexed as

Cerebral PalsyExercise TherapyGaitGait Disorders, NeurologicMuscle, SkeletalRoboticsAdolescentChildElectromyographyFemaleHumansMaleTreatment OutcomeCerebral palsyElectromyographyGaitMuscle synergiesRehabilitation robotics

Identifiers

PMID39920813
PMCPMC11806738

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.