Ambulant adults with spastic cerebral palsy: The validity of lower limb joint angle measurements from sagittal video recordings

2012 ◽  
Vol 35 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Kerstin L. Larsen ◽  
Grethe Maanum ◽  
Kathrine F. Frøslie ◽  
Reidun Jahnsen
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Joint Angle ◽  
Spastic Cerebral Palsy ◽  
Video Recordings ◽  
Angle Measurements

scholarly journals Development of Lower Extremity Strength in Ambulatory Children With Bilateral Spastic Cerebral Palsy in Comparison With Typically Developing Controls Using Absolute and Normalized to Body Weight Force Values

2021 ◽  
Vol 12 ◽  
Author(s):  
Nicolaos Darras ◽  
Eirini Nikaina ◽  
Magda Tziomaki ◽  
Georgios Gkrimas ◽  
Antigone Papavasiliou ◽  
...  
Keyword(s):  
Body Weight ◽  
Cerebral Palsy ◽  
Muscle Strength ◽  
Lower Limb ◽  
Age Groups ◽  
Knee Extensors ◽  
Spastic Cerebral Palsy ◽  
Typically Developing ◽  
Antagonist Muscles ◽  
Muscle Groups

This cross-sectional study aimed to examine the development of lower limb voluntary strength in 160 ambulatory patients with bilateral spastic cerebral palsy (CP) (106 diplegics/54 quadriplegics) and 86 typically developing (TD) controls, aged 7–16 years. Handheld dynamometry was used to measure isometric strength of seven muscle groups (hip adductors and abductors, hip extensors and flexors, knee extensors and flexors, and ankle dorsiflexors); absolute force (AF) values in pounds were collected, which were then normalized to body weight (NF). AF values increased with increasing age (p < 0.001 for all muscle groups), whereas NF values decreased through adolescence (p < 0.001 for all muscle groups except for hip abduction where p = 0.022), indicating that increases in weight through adolescence led to decreases in relative force. Both AF and NF values were significantly greater in TD subjects when compared with children with CP in all muscle and all age groups (p < 0.001). Diplegics and quadriplegics demonstrated consistently lower force values than TD subjects for all muscle groups, except for the hip extensors where TD children had similar values with diplegics (p = 0.726) but higher than quadriplegics (p = 0.001). Diplegic patients also exhibited higher values than quadriplegics in all muscles, except for the knee extensors where their difference was only indicative (p = 0.056). The conversion of CP subjects' force values as a percentage of the TD subjects' mean value revealed a pattern of significant muscle strength imbalance between the CP antagonist muscles, documented from the following deficit differences for the CP muscle couples: (hip extensors 13%) / (hip flexors 32%), (adductors 27%) / (abductors 52%), and (knee extensors 37%) / (knee flexors 53%). This pattern was evident in all age groups. Similarly, significant force deficiencies were identified in GMFCS III/IV patients when compared with TD children and GMFCS I/II patients. In this study, we demonstrated that children and adolescents with bilateral CP exhibited lower strength values in lower limb muscles when compared with their TD counterparts. This difference was more prevalent in quadriplegic patients and those with a more severe impairment. An important pattern of muscle strength imbalance between the antagonist muscles of the CP subjects was revealed.

A Study of Effects of Intervention of Botulinum Toxin- A on Lower Limb in Children with Spastic Cerebral Palsy

2015 ◽  
Vol 26 (4) ◽  
pp. 94-101
Author(s):  
U Singh ◽  
Raj Kumar ◽  
Sanjay Wadhwa ◽  
SL Yadav
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Range Of Motion ◽  
Lower Limb ◽  
Stride Length ◽  
Botulinum Toxin A ◽  
Step Length ◽  
Spastic Cerebral Palsy ◽  
Toxin A ◽  
Base Of Support

Abstract Objective Analysis of clinical gait pattern, change in spasticity and range of motion (ROM) in cerebral palsy patient (CP) with spastic lower limb muscle after injecting botulinum toxin- A. Study Design Prospective study Methods 28 children (18 male and 10 female) with spastic CP had problems in normal walking, aged 2–9 years (mean age 4.65 years), consecutively treated in the PMR department over a 2-year period, were prospectively followed-up and clinically assessed pre- and post-treatment (at 2 weeks and 2 months) both objectively and subjectively. Objective assessment included gait parameters -- stride length, cadence, velocity, step length, base of support; active and passive range of motion (ROM), (measured by goniometry) and spasticity on modified Ashworth scale. Subjective assessment was done by asking questionnaire in terms of comfort, ease of care, perineal hygiene, walking. Injections were given using clinical palpatory method on OPD basis. All patients received botulinum toxin-A injections, followed with exercises and activities and orthosis as needed. Results Significant improvement was achieved for spasticity reduction in gastrocnemius (p< 0.001), hamstring and adductor (p=0.050), ankle AROM & PROM (p< 0.001), active knee extension (p=0.009), popliteal angle (p=0.015) and percentage left and right foot contact (p< 0.001), whereas non-significant change was observed in step length, cadence, velocity, stride length, and base of support. Parents felt subjective improvement in most of the cases (>90%). Conclusions Botulinum toxin- A injection is effective in the treatment of spastic lower limb muscles for equinus/ crouching/scissoring gait in cerebral palsy children. The treatment was feasible and easily implemented. Botulinum toxin- A injections were well tolerated, yielded no serious treatment-related adverse events.

Can muscle morphology and internal composition of lower limb muscles explain strength and gait deficits in children with spastic cerebral palsy?

2017 ◽  
Vol 57 ◽  
pp. 114-115
Author(s):  
Britta Hanssen ◽  
Simon-Henri Schless ◽  
Marije Goudriaan ◽  
Lynn Bar-On ◽  
Kaat Desloovere
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Spastic Cerebral Palsy ◽  
Muscle Morphology ◽  
Lower Limb Muscles ◽  
Limb Muscles

Lower limb muscle volumes in bilateral spastic cerebral palsy

2014 ◽  
Vol 36 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Jonathan J. Noble ◽  
Nicola R. Fry ◽  
Andrew P. Lewis ◽  
Stephen F. Keevil ◽  
Martin Gough ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Spastic Cerebral Palsy ◽  
Lower Limb Muscle ◽  
Limb Muscle

P55: Lower limb muscle fatigue during walking in children with spastic cerebral palsy

2017 ◽  
Vol 57 ◽  
pp. 278-279
Author(s):  
Maaike M Eken ◽  
Siri M Braendvik ◽  
Han Houdijk ◽  
Annet Dallmeijer ◽  
Ellen Marie Bardal ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Muscle Fatigue ◽  
Lower Limb ◽  
Spastic Cerebral Palsy ◽  
Lower Limb Muscle ◽  
Limb Muscle

scholarly journals Lower extremity soft tissue surgery in spastic cerebral palsy: experience from a government rehabilitation unit

2018 ◽  
Vol 4 (2) ◽  
pp. 214
Author(s):  
Adiveppa Hosangadi ◽  
Anand Varma ◽  
Surykanth Kalluraya
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Lower Limb ◽  
Operative Procedure ◽  
Lower Limbs ◽  
Spastic Cerebral Palsy ◽  
Functional Abilities ◽  
Rehabilitation Unit ◽  
Lower Limb Surgery ◽  
Soft Tissue Surgery

<p class="abstract"><strong>Background:</strong> <span>Spastic cerebral palsy (CP) remains the most common type of CP and may be managed surgically or non-surgically depending upon its severity. Recent advances have replaced single-level surgery by the concept of multilevel surgery where multiple levels of musculoskeletal pathology, in one/both lower limbs, are addressed during one operative procedure, requiring only one hospital admission and one period of rehabilitation. This study assessed the outcome of lower limb soft tissue surgery in children with spastic CP in a government rehabilitation unit and measured its feasibility with limited infrastructure facilities and patient compliance</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>The study comprised of 26 patients aged between 2-12 years. Physical examination and GMFCS scores were recorded and evaluation of sitting balance, standing balance and gait were done. Musculotendinous soft tissue lower limb surgery was performed at one or more levels unilaterally or bilaterally and the results were interpreted</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span>Complete or near complete correction of deformities were attained by all children postoperatively. Significant improvements were noted in the gross motor functional classification system (GMFCS) scores. All parents and children were satisfied with the surgical outcome and reported improvement in functional abilities and locomotion in the follow-up along with better quality of life and mobility</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span>Lower limb soft tissue surgery is a valuable aid in improving functional abilities and locomotion in children with spastic CP. Surgery should be undertaken depending upon clinical indications and can be successfully carried out in government hospitals with ordinary infrastructure in developing countries as well</span><span lang="EN-IN">.</span></p>

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