Interventions and lower‐limb macroscopic muscle morphology in children with spastic cerebral palsy: a scoping review

Author(s):  
Fenna Walhain ◽  
Kaat Desloovere ◽  
Marlies Declerck ◽  
Anja Van Campenhout ◽  
Lynn Bar‐On
2017 ◽  
Vol 57 ◽  
pp. 114-115
Author(s):  
Britta Hanssen ◽  
Simon-Henri Schless ◽  
Marije Goudriaan ◽  
Lynn Bar-On ◽  
Kaat Desloovere

2021 ◽  
Vol 12 ◽  
Author(s):  
Nicolaos Darras ◽  
Eirini Nikaina ◽  
Magda Tziomaki ◽  
Georgios Gkrimas ◽  
Antigone Papavasiliou ◽  
...  

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.


2020 ◽  
Vol 62 (10) ◽  
pp. 1138-1146
Author(s):  
Hajar Almoajil ◽  
Nichola Wilson ◽  
Tim Theologis ◽  
Sally Hopewell ◽  
Francine Toye ◽  
...  

2012 ◽  
Vol 35 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Kerstin L. Larsen ◽  
Grethe Maanum ◽  
Kathrine F. Frøslie ◽  
Reidun Jahnsen

2017 ◽  
Vol 57 ◽  
pp. 116-117
Author(s):  
Abir Massaad ◽  
Ayman Assi ◽  
Ziad Bakouny ◽  
Wafa Skalli ◽  
Ismat Ghanem

2015 ◽  
Vol 26 (4) ◽  
pp. 94-101
Author(s):  
U Singh ◽  
Raj Kumar ◽  
Sanjay Wadhwa ◽  
SL Yadav

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.


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

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