Acute Effects of Intramuscular and Passive Stretching on Muscle Stiffness and Spasticity in Children with Cerebral Palsy

It is still widely believed that exaggerated stretch reflexes and increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). However, no study has directly measured stretch reflex activity during gait in these children. We investigated sensory feedback mechanisms during walking in 20 CP children and 41 control children. Stretch responses in plantar flexor muscles evoked in stance showed an age-related decline in control but not CP children. In swing the responses were abolished in control children, but significant responses were observed in 14 CP children. This was related to reduced activation of dorsiflexors in swing. Removal of sensory feedback in stance produced a drop in soleus activity of a similar size in control and CP children. Soleus activity was observed in swing to the same extent in control and CP children. Removal of sensory feedback in swing caused a larger drop in soleus activity in control children than in CP children. The lack of age-related decline in stretch reflexes and the inability to suppress reflexes in swing is likely related to lack of maturation of corticospinal control in CP children. Since soleus activity was not seen more frequently than in control children in swing and since sensory feedback did not contribute more to their soleus activity, spasticity is unlikely to contribute to foot drop and toe walking. We propose that altered central drive to the ankle muscles and increased passive muscle stiffness are the main causes of foot drop and toe walking.

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The Effect of Horseback Riding on Symmetry of Mechanical Properties of Muscles of Beginner and Advanced Riders with Cerebral Palsy

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i12.687 ◽

2019 ◽

Vol 1 (12) ◽

Author(s):

Laura Straubergaitė ◽

Vilma Juodžbalienė

Keyword(s):

Mechanical Properties ◽

Cerebral Palsy ◽

Muscle Tone ◽

Mechanical Energy ◽

Three Dimensional ◽

Gluteus Medius ◽

Muscle Stiffness ◽

Erector Spinae ◽

Horseback Riding ◽

Children With Cerebral Palsy

Research background. Since muscle activity of children with cerebral palsy is often unbalanced and this might be caused by passive mechanical properties of the muscle, it would be benefcial to analyze the properties using instrumental methods in order to evaluate the change which is induced by practicing horseback riding. Nevertheless, little literature was found on children with cerebral palsy muscle passive mechanical properties and its change while horseback The aim of the research was to evaluate and compare symmetry of mechanical properties of muscles of beginner and advanced riders with cerebral palsy while Methods. The mechanical properties of the muscles’ (m. gluteus medius, m. erector spinae lumbar part) were evaluated using MYOTON-3 Results. A great difference between both body side muscle’s (Gluteus medius and Erector spinae) tone asymmetry (> 10%) while standing increased. It can be explained by the fact that during the frst horseback riding exercises (which is similar to learning a new locomotor activity) a greater tension (muscle tone) is observed. Results on logarithmic gluteus medius and erector spinae muscles decrement asymmetry received after the fnal horseback riding exercise revealed that ten sessions of horseback riding is not inﬂuential enough to affect the elasticity of the mentioned muscle. The greater decrement shows depletion of mechanical energy of muscle structure. A great difference between both body sides muscle stiffness asymmetry after the tenth horseback riding exercise revealed that three-dimensional movements initiated by the horse are not inﬂuential enough in decreasing the gluteus medius and ererctor spinae muscles stiffness asymmetry for advanced and beginner horsemen. In the meantime the asymmetry of lumbar erector spinae muscle had increased for both beginners and advanced Conclusion. Ten sessions of horseback riding had not enough inﬂuence on decreasing asymmetry of gluteus medius and erector spinae muscles passive mechanical properties for both beginners and advanced riders.Keywords: horseback riding, cerebral palsy, passive mechanical properties,symmetry.

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