Effect of Enhancing Sensory Input on Motor Output in Infants with Myelomeningocele (MMC)

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Investigators: Caroline Teulier, Beth A Smith, Jill Heathcock, Victoria Moerchen, Karin Muraszko, and Beverly D Ulrich.

With this set of three studies we want to determine the effect of enhancing the sensory input available on the activation of the neuromotor system, monitored kinematically and kinetically. We are addressing the potential change in responsiveness related to age, to different forms of sensory information (visual, tactile, load), and to combinations of enhanced sensory input that may be needed to surpass their threshold of sensitivity to sensory information.

In Study One we are testing the impact of enhancing one single source of sensory input at a time. We are testing 12 babies in each of two age groups, 2-5 and 7-10 months, all with lesions within the lumbar or sacral areas. We support them upright on a small motorized treadmill, use motion capture and EMG to monitor steps, non-stepping leg motion, and muscle activation patterns under the following treadmill conditions: baseline trials (typical smooth belt), visual flow enhancement (belt covered in a checkerboard design), enhanced tactile pressure on the sole (weight added to legs), enhanced joint input (babies positioned near the rear edge of the belt to limit stance duration causing ankle and hip to extend rapidly as foot “drops off” the edge quickly), enhanced stance (Velcro socks on a belt covered with fabric increases foot contact in stance), enhanced friction (Dycem covered belt increases coefficient of friction).

In Study Two we combine pairs of stimuli tested in Study One to determine if their combination will be more effective than one alone. The age groups remain the same but sample size is 6 per age group. Conditions are: baseline, enhanced visual flow plus friction, visual flow plus enhanced joint input, friction plus enhanced joint input, enhanced joint input plus enhanced tactile pressure on the sole.

In Study Three we use manual manipulation of the legs in varying combinations, interspersed with baseline trials, to determine if this increased (primes) muscle activity and leads, subsequently, to increased voluntary step production.

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