Cerebral palsy in adults: Independent effects of muscle strength and muscle tone

Abstract

Maruishi M, Mano Y, Sasaki T, Shinmyo N, Sato H, Ogawa T. Cerebral palsy in adults: independent effects of muscle strength and muscle tone. Arch Phys Med Rehabil 2001;82:637-41. Objective: To investigate clinical characteristics and their contribution to activities of daily living (ADLs) in adults with cerebral palsy (CP). Design: Descriptions of the clinical features of medical disorders; survey. Setting: Rehabilitation counseling center in Japan. Patients: A case series of 256 patients (140 men, 116 women; mean age, 31.6yr; range, 17-83yr) admitted to a rehabilitation center from January 1995 to December 1997. Main Outcome Measures: Characteristics investigated included severity of mental retardation, topography of motor deficits, motor power by manual muscle testing, muscle tone rated by using the muscle tone scale, deformity, sensory disturbance, and pain. ADLs were evaluated with the Barthel Index. Results: Patients showed severe impairment in terms of the Ashworth scale for grading spasticity and deformity, and moderate impairment on manual muscle testing. ADLs were influenced significantly by topography of motor deficits, manual muscle test scores, and muscle tone scale assessment (p <.0001). The muscle tone scale findings showed a significant correlation with deformity (p <.0001), but did not correlate with manual muscle testing. ADLs were affected by muscle power and muscle tone independently. Conclusion: Adults with CP showed markedly increased muscle tone and moderate muscle weakness. These 2 factors did not correlate with each other, and were independently responsible for worse ADLs. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation