Comparison of calf muscle architecture between Asian children with spastic cerebral palsy and typically developing peers.

Jinling Li,Christos Papadelis,Buyun Guan,Lu He,Hongmei Tang,Ying Chen,Kaishou Xu

doi:10.1371/journal.pone.0190642

Jinling Li, Christos Papadelis + Show 5 more

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https://doi.org/10.1371/journal.pone.0190642

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Journal: PloS one	Publication Date: Jan 5, 2018
Citations: 13	License type: CC BY 4.0

Affiliation: Guangzhou Medical University

Abstract

ObjectiveTo compare the muscle thickness, fascicle length, and pennation angle of the gastrocnemius, soleus, and tibialis anterior between Asian children with spastic cerebral palsy (CP) and typically developing (TD) peers.MethodsThis cross-sectional study involved a total of 72 children with hemiplegic CP (n = 24), and diplegic CP (n = 24) and their TD peers (n = 24). Muscle architecture was measured at rest using ultrasound. Clinical measures included gross motor function and a modified Ashworth scale.ResultsThe thicknesses of the tibialis anterior and medial gastrocnemius muscles were smaller in the affected calf of children with CP (p<0.05) than in those of their TD peers. Additionally, the lengths of the lateral gastrocnemius and soleus fascicle were shorter (p<0.05) in children with diplegic CP than in their TD peers. The fascicle length was shorter in the affected calf of children with CP (p<0.05) than in the calves of their TD peers or the unaffected calf of children with hemiplegic CP. However, the length of the lateral gastrocnemius fascicle was similar between the two legs of children with hemiplegic CP. The pennation angles of the medial gastrocnemius and soleus muscles were larger (p<0.05) in the affected calf in children with hemiplegic CP than in the calves of their TD peers. The fascicle length of the lateral gastrocnemius and the thickness of the soleus muscle were positively correlated with gross motor function scores in children with CP (p<0.05).ConclusionsMuscle thickness and fascicle length were lower in the affected tibialis anterior, gastrocnemius, and soleus in children with spastic CP. These changes may limit the ability to stand and walk, and indicate a need to strengthen the affected muscle.

Highlights

The key feature of spastic cerebral palsy (CP) is spasticity, which causes significant alterations to muscle morphology and architecture over time despite the non-progressive nature of its brain lesions.[1,2] The spastic muscles are often shorter as a result of insufficient stretching
Muscle thickness and fascicle length were lower in the affected tibialis anterior, gastrocnemius, and soleus in children with spastic CP
We demonstrated that muscle thickness and fascicle length were significantly lower in the affected than in the typically developing (TD) muscles and in the affected than in the unaffected muscles for the tibialis anterior, gastrocnemius, and soleus muscles

Summary

Introduction

The key feature of spastic cerebral palsy (CP) is spasticity, which causes significant alterations to muscle morphology and architecture over time despite the non-progressive nature of its brain lesions.[1,2] The spastic muscles are often shorter as a result of insufficient stretching. A muscle’s function is indicated by its architecture, including its muscle thickness, fascicle length, and pennation angle[8,9,10,11,12]. Muscle excursion is reflected in fascicle length, which impacts force generation and the maximum shortening speed[9]. Muscle morphology and structure are altered in children with CP to some degree as a result of secondary impairments, such as disuse, spasticity, and immobilization[15,16,17,18,19,20,21,22,23]. Muscle architecture is closely related to muscle excursion, the generation of force and power, and maximum muscle shortening speed. It is very important to determine whether and how its muscle architecture is altered

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