Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy

Francesca Martelli, Stefano Rossi, Flaminia Frascarelli, Marco Germanotta, Maurizio Petrarca, Enrico Castelli, Paolo Cappa

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

The main object of this study is to quantify the effect of botulinum toxin on the dynamic ankle impedance (ZAnkle) in children with cerebral palsy (CP). The effect was evaluated by comparing the ZAnkle before and one month later the botulinum injection in gastrocnemius muscle. A cohort of six children with CP was involved in the study. All data were gathered by the pediatric version of the Anklebot (PediAnklebot), a backdrivable robot for ankle rehabilitation. The robot applied random torque perturbations to the ankle in both inversion-eversion (IE) and dorsi-plantar flexion (DP) direction. The ankle angular displacements and torques were gathered by encoders and load cells mounted on the PediAnklebot. The ZAnkle was estimated by a Multiple-Input Multiple-Output system identification (MIMO). The ZAnkle was evaluated in three frequency ranges: 0 Hz ≤ f ≤ 2 Hz, 2 Hz ≤ f ≤ 5 Hz, and 5 Hz ≤ f ≤ 8 Hz, addressed as low, mid and high frequency ranges. In each selected range the impedance anisotropy was quantified by the Direction Dependent Map (DDM) and the DDM shape was evaluated via the ZRatio, defined as the ratio between the maximum and the minimum value assumed by ZAnkle. Statistically significant decreases induced by the toxin treatment were found for ZAnkie in IE direction only in high frequency range and in DP direction for the three frequency ranges here examined. Moreover, a significant decrease of ZRatio emerged at mid frequency range. In conclusion, the botulinum toxin injection mainly affected the movement involving gastrocnemius, i.e. the dorsi-plantar flexion, and it did not affect the ankle impedance in inversion-eversion. These findings implied a clear variation of muscle elasticity and can provide an objective and quantitative support in the neurorehabilitation treatments of pediatric population with neurological diseases.

Original languageEnglish
Title of host publication2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings
PublisherInstitute of Electrical and Electronics Engineers Inc.
ISBN (Electronic)9781467391726
DOIs
Publication statusPublished - Aug 4 2016
Event11th IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Benevento, Italy
Duration: May 15 2016May 18 2016

Other

Other11th IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016
CountryItaly
CityBenevento
Period5/15/165/18/16

Fingerprint

Pediatrics
frequency ranges
impedance
injection
Muscle
Torque
Robots
inversions
muscles
robots
torque
Patient rehabilitation
Elasticity
Loads (forces)
Identification (control systems)
Anisotropy
MIMO (control systems)
system identification
coders
elastic properties

Keywords

  • ankle impedance
  • botulinum toxin
  • cerebral palsy
  • joint stiffness
  • PediAnklebot

ASJC Scopus subject areas

  • Signal Processing
  • Biomedical Engineering
  • Instrumentation

Cite this

Martelli, F., Rossi, S., Frascarelli, F., Germanotta, M., Petrarca, M., Castelli, E., & Cappa, P. (2016). Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy. In 2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings [7533709] Institute of Electrical and Electronics Engineers Inc.. https://doi.org/10.1109/MeMeA.2016.7533709

Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy. / Martelli, Francesca; Rossi, Stefano; Frascarelli, Flaminia; Germanotta, Marco; Petrarca, Maurizio; Castelli, Enrico; Cappa, Paolo.

2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings. Institute of Electrical and Electronics Engineers Inc., 2016. 7533709.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Martelli, F, Rossi, S, Frascarelli, F, Germanotta, M, Petrarca, M, Castelli, E & Cappa, P 2016, Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy. in 2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings., 7533709, Institute of Electrical and Electronics Engineers Inc., 11th IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016, Benevento, Italy, 5/15/16. https://doi.org/10.1109/MeMeA.2016.7533709
Martelli F, Rossi S, Frascarelli F, Germanotta M, Petrarca M, Castelli E et al. Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy. In 2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings. Institute of Electrical and Electronics Engineers Inc. 2016. 7533709 https://doi.org/10.1109/MeMeA.2016.7533709
Martelli, Francesca ; Rossi, Stefano ; Frascarelli, Flaminia ; Germanotta, Marco ; Petrarca, Maurizio ; Castelli, Enrico ; Cappa, Paolo. / Estimation of multivariable dynamic ankle impedance after botulinum toxin injection in children with cerebral palsy. 2016 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2016 - Proceedings. Institute of Electrical and Electronics Engineers Inc., 2016.
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