Muscle Morphology In Children Research Articles

Long-term effects of different number of botulinum toxin injections into the gastrocnemius muscle on function and muscle morphology in children with cerebral palsy

BackgroundBotulinum toxin (BoNT) injections are used to reduce spasticity, and sometimes repeated injections of the toxin are required. The aim of this study is to investigate the effects of the number of injections of BoNT into the gastrocnemius muscle on function, muscle morphology, muscle stiffness and muscle vascularization in children with cerebral palsy (CP). MethodsThe study included 22 children with unilateral or bilateral spastic type CP aged 5-13 years who had previously received one, two, or three BoNT injections into the gastrocnemius muscle. A total of 29 gastrocnemius muscles were evaluated. Gastrocnemius muscle morphology (muscle cross-sectional area, thickness, fascicle length and pennation angle) was examined by ultrasonography, muscle stiffness by shear wave ultrasound elastography and muscle vascularization by Superb Microvascular Imaging. The functional status of the children was evaluated by the Gross Motor Function Measurement, the Timed-Up-and-Go Test, the Squat Test, the Vertical Jumping Test and the Sit-and-Reach Test. ResultsIn the motor functions and muscle morphology values were similar in all three groups (p>0.05). Muscle stiffness values were higher (p=0.035) and vascularization values were lower (p=0.03) in the group that received three injections compared to the groups that received one injection. There was a moderate positive correlation of the number of BoNTs with muscle stiffness (p<0.05, r=0.454) and a moderate negative correlation with muscle vascularization (p<0.05, r=-0.497). ConclusionsRepeated BoNT applications have no effect on motor functions and muscle morphology in children with CP, whereas BoNT injections administered three times increase muscle stiffness and decrease vascularization.

The contribution of physical activity and nutrition to muscle morphology in children with spastic cerebral palsy

The contribution of physical activity and nutrition to muscle morphology in children with spastic cerebral palsy

Measuring skeletal muscle morphology in children with cerebral palsy – A scoping review update of the last 4 years

Measuring skeletal muscle morphology in children with cerebral palsy – A scoping review update of the last 4 years

Skeletal muscle fibre morphology in childhood-insights into myopenia in pediatric liver disease.

Skeletal muscle morphology in healthy children changes with age. Liver disease may preferentially affect type II fibres in adults with end-stage liver disease (ESLD). More research is needed on the effects of ESLD on muscle morphology in children.

Muscle morphology in children with spastic cerebral palsy without history of treatment in Suriname

Muscle morphology in children with spastic cerebral palsy without history of treatment in Suriname

The short-term impact of Botulinum Neurotoxin type a injections on lower-limb muscle morphology in children with spastic Cerebral Palsy

The short-term impact of Botulinum Neurotoxin type a injections on lower-limb muscle morphology in children with spastic Cerebral Palsy

Are muscle spasticity patterns related to alterations in muscle morphology in children with spastic cerebral palsy?

Are muscle spasticity patterns related to alterations in muscle morphology in children with spastic cerebral palsy?

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

To identify and map studies that have assessed the effect of interventions on lower-limb macroscopic muscle-tendon morphology in children with spastic cerebral palsy (CP). We conducted a literature search of studies that included pre- and post-treatment measurements of lower-limb macroscopic muscle-tendon morphology in children with spastic CP. Study quality was evaluated and significant intervention effects and effect sizes were extracted. Twenty-eight articles were identified. They covered seven different interventions including stretching, botulinum neurotoxin A (BoNT-A), strengthening, electrical stimulation, whole-body vibration, balance training, and orthopaedic surgery. Study quality ranged from poor (14 out of 28 studies) to good (2 out of 28). Study samples were small (n=4-32) and studies were variable regarding which muscles and macroscopic morphological parameters were assessed. Inconsistent effects after intervention (thickness and cross-sectional area for strengthening, volume for BoNT-A), no effect (belly length for stretching), and small effect sizes were reported. Intervention studies reporting macroscopic muscle-tendon remodelling after interventions are limited and heterogeneous, making it difficult to generalize results. Studies that include control groups and standardized assessment protocols are needed to improve study quality and data synthesis. Lack or inconclusive effects at the macroscopic level could indicate that the effects of interventions should also be evaluated at the microscopic level. Muscle-targeted interventions to remodel muscle morphology are not well understood. Studies reporting macroscopic muscle remodelling following interventions are limited and heterogeneous. Passive stretching may preserve but does not increase muscle length. The effects of isolated botulinum neurotoxin A injections on muscle volume are inconsistent. Isolated strengthening shows no consistent increase in muscle volume or thickness.

Effect of botulinum toxin type-A injections on medial gastrocnemius muscle morphology in children with spastic cerebral palsy: A follow-up study

SrxBa3-xCo2Fe24O41 Z-type hexaferrites have been prepared by the citric acid sol-gel method, and the structural and electromagnetic properties have been investigated in detail. The results showed that single-phase Z-type hexaferrites were observed, and all samples exhibited excellent soft magnetic properties. For the sample with x = 1.5, a high resonant frequency fr = 3.50 GHz and initial permeability μ′ = 2.76 at 100 MHz was obtained. The calculated frequency dependence spectrum of the reflection loss (RL) showed a largest absorbing value of −48.5 dB at 17.6 GHz with a thickness of 5.0 mm. With the increasing thickness t, two local minimum RL values were observed from the RL-t curve. One was −43.6 dB at t = 4.3 mm and the other was −45.8 dB at t = 2.8 mm. The dependence of percentage bandwidth WP on thickness t was studied. As t increasing, WP increased firstly and then slowly decreased, reaching the maximum value of 96.1% at t = 3.3 mm.

The effect of different interventions on lower limb muscle morphology in children with spastic cerebral palsy: a systematic literature review

The effect of different interventions on lower limb muscle morphology in children with spastic cerebral palsy: a systematic literature review

Normative data of muscle fiber diameter of vastus lateralis during childhood: a field test.

Currently, our knowledge of standard data for muscle morphology in children is largely limited to the 1969 article by Brooke and Engel (BE). In 2016, we reported normal muscle morphology from vastus lateralis biopsies in ambulant children with cerebral palsy (CP). This report compares our normal biopsy results against BE standard value criteria. Single-blind prospective cross-sectional study design. Results of biopsies taken in ambulant children with CP were normal according to morphometry and light and electron microscopy; however, only 5 of 10 fulfilled the BE standard value criteria. This short report highlights the requirement for contemporary age-specific normative data from a larger number of biopsies, including typically developing children. Review of the literature suggests that biopsy material may be available from typically developing children who were control patients in research trials. This morphometric data could contribute to expanding the normative data set. Muscle Nerve 59:590-590, 2019.

Alterations of treatment-naïve pelvis and thigh muscle morphology in children with cerebral palsy

Lower limb (LL) muscle morphology and growth are altered in children with cerebral palsy (CP). Muscle alterations differ with age and with severity of motor impairment, classified according to the gross motor classification system (GMFCS). Muscle alterations differ also with orthopedic intervention, frequently performed at the level of the shank muscles since an early age, such as the gastrocnemius. The aim was to investigate the alterations of treatment-naïve pelvis and thigh muscle lengths and volumes in children with GMFCS levels I and II, of varying ages.17 children with CP (GMFCS I: N = 9, II: N = 8, age: 11.7 ± 4 years), age-matched to 17 typically developing (TD) children, underwent MRI of the LL. Three-dimensional reconstructions of the muscles were performed bilaterally. Muscle volumes and lengths were calculated in 3D and compared between groups. Linear regression between muscle volumes and age were computed.Adductor-brevis and gracilis lengths, as well as rectus-femoris volume, were decreased in GMFCS I compared to TD (p < 0.05). Almost all the reconstructed muscle volumes and lengths were found to be altered in GMFCS II compared to TD and GMFCS I. All muscle volumes showed significant increase with age in TD and GMFCS I (R2 range: 0.3–0.9, p < 0.05). Rectus-femoris, hamstrings and adductor-longus showed reduced increase in the muscle volume with age in GMFCS II when compared to TD and GMFCS I.Alterations of treatment-naïve pelvis and thigh muscle volumes and lengths, as well as muscle growth, seem to increase with the severity of motor impairment in ambulant children with CP.

Muscle and tendon morphology alterations in children and adolescents with mild forms of spastic cerebral palsy

BackgroundEarly detection of changes at the muscular level before a contracture develops is important to gain knowledge about the development of deformities in individuals with spasticity. However, little information is available about muscle morphology in children with spastic diplegic cerebral palsy (CP) without contracture or equinus gait. Therefore, the aim of this study was to compare the gastrocnemius medialis (GM) and Achilles tendon architecture of children and adolescents with spastic CP without contracture or equinus gait to that of typically developing (TD) children.MethodsTwo-dimensional ultrasonography was used to assess the morphological properties of the GM muscle and Achilles tendon in 10 children with spastic diplegic CP (Gross Motor Function Classification System level I–II) and 12 TD children (mean age 12.0 (2.8) and 11.3 (2.5) years, respectively). The children with CP were not restricted in the performance of daily tasks, and therefore had a high functional capacity. Mean muscle and tendon parameters were statistically compared (independent t-tests or Mann-Whitney U-tests).ResultsWhen normalized to lower leg length, muscle-tendon unit length and GM muscle belly length were found to be significantly shorter (p < 0.05, effect size (ES) = 1.00 and 0.98, respectively) in the children with spastic CP. Furthermore, there was a tendency for increased Achilles tendon length when expressed as a percentage of muscle-tendon unit length (p = 0.08, ES = − 0.80) in the individuals with CP. This group also showed shorter muscle fascicles (3.4 cm vs. 4.4 cm, p < 0.01, ES = 1.12) and increased fascicle pennation angle (21.9° vs. 18.1°, p < 0.01, ES = − 1.36, respectively). However, muscle thickness and Achilles tendon cross-sectional area did not differ between groups. Resting ankle joint angle was significantly more plantar flexed (− 26.2° vs. − 20.8°, p < 0.05, ES = 1.06) in the children with CP.ConclusionsMorphological alterations of the plantar flexor muscle-tendon unit are also present in children and adolescents with mild forms of spastic CP. These alterations may contribute to functional deficits such as muscle weakness, and therefore have to be considered in the clinical decision-making process, as well as in the selection of therapeutic interventions.

Radiological and clinical findings following distraction osteogenesis of the lower limb in children with or without botox injection: A preliminary report

Context: Limb lengthening correction according to Ilizarov distraction osteogenesis (DO) usually yields excellent results. While pediatric orthopedic surgeons anecdotally report that botulinum toxin A (Botox) alleviates spasm and pain during DO, no study has examined the effects of this surgery and Botox injection on muscle morphology in children. Aims: (1) To evaluate the clinical and radiological effects of lower limb lengthening in children and (2) the effects of adjunctive Botox muscle injection. Setting and Design: This was a center and randomized control trial. Methods: Seven children underwent tibial (n = 3) or femoral lengthening (n = 4) and were randomized to receive either a Botox or sterile saline solution. Quality of life and functional mobility outcomes, muscle testing, and magnetic resonance imaging examination were obtained at baseline, 12-, and 24-month postoperative. Muscle measurements were acquired on axial T1-weighted images and included: (1) total cross-sectional area (TCSA), (2) functional cross-sectional area (FCSA, fat-free area), (3) ratio of FCSA to TCSA, and (4) asymmetry between sides. Results: Physical performance improved at 12- and 24-month postoperative. Muscle strength remained functional across the three time points. A decrease in TCSA and FCSA was observed at 12-month follow-up in the operated thigh of patients undergoing femur lengthening, but muscle mass was regained at 24 months. However, TCSA and FCSA remained lower in the operated femur at 24 months. Similar findings were also observed in patients who underwent tibial lengthening. Patients in the Botox group appeared to have a slightly greater decrease in muscle mass and increase in fatty infiltration in the operated leg. Conclusions: Children undergoing DO preserved their muscle strength and improved physical performance 2-year postoperative. Our results suggest that muscle size and muscle mass remained lower in the operated leg; a finding that was slightly more prominent in children who received a Botox injection.

Knee Moment-Angle Characteristics and Semitendinosus Muscle Morphology in Children with Spastic Paresis Selected for Medial Hamstring Lengthening.

To increase knee range of motion and improve gait in children with spastic paresis (SP), the semitendinosus muscle (ST) amongst other hamstring muscles is frequently lengthened by surgery, but with variable success. Little is known about how the pre-surgical mechanical and morphological characteristics of ST muscle differ between children with SP and typically developing children (TD). The aims of this study were to assess (1) how knee moment-angle characteristics and ST morphology in children with SP selected for medial hamstring lengthening differ from TD children, as well as (2) how knee moment-angle characteristics and ST morphology are related. In nine SP and nine TD children, passive knee moment-angle characteristics and morphology of ST (i.e. fascicle length, muscle belly length, tendon length, physiological cross-sectional area, and volume) were assessed by hand-held dynamometry and freehand 3D ultrasound, respectively. At net knee flexion moments above 0.5 Nm, more flexed knee angles were found for SP compared to TD children. The measured knee angle range between 0 and 4 Nm was 30% smaller in children with SP. Muscle volume, physiological cross-sectional area, and fascicle length normalized to femur length were smaller in SP compared to TD children (62%, 48%, and 18%, respectively). Sixty percent of the variation in knee angles at 4 Nm net knee moment was explained by ST fascicle length. Altered knee moment-angle characteristics indicate an increased ST stiffness in SP children. Morphological observations indicate that in SP children planned for medial hamstring lengthening, the longitudinal and cross-sectional growth of ST muscle fibers is reduced. The reduced fascicle length can partly explain the increased ST stiffness and, hence, a more flexed knee joint in these SP children.

Knee moment-knee angle characteristics and muscle morphology in children with spastic cerebral palsy selected for medial hamstring lengthening

Knee moment-knee angle characteristics and muscle morphology in children with spastic cerebral palsy selected for medial hamstring lengthening

Mandibular muscle morphology in children with different vertical facial patterns: A 3-dimensional computed tomography study

This study was undertaken to assess whether 3-dimensional computed tomography (CT) can be used to evaluate the relationships between the mandibular muscles and craniofacial morphology in children with different underlying vertical facial patterns. Twenty children (mean age, 11.9 +/- 1.6 years) underwent cranial CT examination. Three-dimensional CT images were reconstructed for the evaluation of the cross-sectional size, volume, and spatial orientation of the masseter, medial pterygoid, and lateral pterygoid muscles. These muscle factors were also assessed in relation to vertical and transverse craniofacial form. Positive correlations were found between the muscles' cross-sectional area and volume, and between muscle size and transverse facial width. Despite the limited sample size, differences were also found in the orientation of the masseter and medial pterygoid muscles in growing patients with different underlying vertical facial patterns. Three-dimensional CT can be used for the assessment of soft- and hard-tissue dentofacial forms. Clinicians should note the potential differences in muscle cross-sectional area, volume, and orientation in subjects with different underlying vertical facial patterns.