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Développement méthodologique pour l'analyse des troubles de la commande du membre supérieur des enfants avec une paralysie cérébrale unilatérale spastique : implications pour les thérapies et traitements associés

Abstract : Children with unilateral spastic cerebral palsy have restricted movement of one upper limb.One of the symptoms responsible for this limitation is spastic co-activation, which is an excessive activation from specific muscles opposing the movement. In clinical routine, no tool can detect which muscles have a pathological activation.Electromyographic signals, measured non-invasively, can discriminate pathological muscle activations.However, they are rarely measured at the upper limb of children with cerebral palsy, due to methodological and statistical difficulties. This thesis addresses these difficulties. Electromyographic signals of upper limb muscles were measured in 63 children with and without unilateral spastic cerebral palsy, as part of 5 research studies.The first two studies consisted in detecting and characterizing abnormal muscle activations in children with cerebral palsy, in order to target relevant electromyographic parameters. The third study validated the measure of upper limb electromyography, and evaluated its variability.Fourth and fifth studies applied the developed methodology to clinical problems: the distinction, for each child, of the muscles responsible for active movement restrictions; the evaluation of muscle activation modifications following a therapy.Methodological development associated with these studies assessed the reliability of upper limb electromyography, and showed its strong potential for the “functional diagnosis” of children with cerebral palsy.
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Submitted on : Thursday, May 16, 2019 - 12:32:04 PM
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Aurélie Sarcher. Développement méthodologique pour l'analyse des troubles de la commande du membre supérieur des enfants avec une paralysie cérébrale unilatérale spastique : implications pour les thérapies et traitements associés. Médecine humaine et pathologie. Université de Bretagne occidentale - Brest, 2018. Français. ⟨NNT : 2018BRES0078⟩. ⟨tel-02131492⟩

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