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Spastic velocity threshold constrains functional performance in cerebral palsy
Ann E Tuzson1, Kevin P Granata, Mark F Abel
1Motion Analysis and Motor Performance Laboratory, Kluge Children's Rehabilitation Center, University of Virginia, Charlottesville, VA 24061, USA.
Insights
This study quantifies spasticity in children with cerebral palsy (CP), finding that spastic threshold velocity impacts knee movement during fast walking and correlates with functional ability. This velocity-based assessment aids in understanding spasticity
Area of Science:
- Neurology
- Biomechanical Engineering
- Pediatric Rehabilitation
Background:
- Spasticity is a common motor disorder in children with cerebral palsy (CP), affecting muscle tone and movement.
- Quantitative assessments are needed to better understand the impact of spasticity on functional mobility in children with CP.
Purpose of the Study:
- To evaluate a quantitative, velocity-based assessment of spasticity in the quadriceps and hamstrings muscles of children with CP.
- To determine the effect of spasticity on knee joint velocities during fast gait in children with CP.
Main Methods:
- A quantitative comparison of neuromuscular and biomechanical performance was conducted between 18 ambulatory children with CP and 11 age-matched controls.
- Spastic threshold velocity was measured using electromyography during passive isovelocity knee movements.
- Knee angular velocity during fast walking, Gross Motor Function Measure (GMFM) scores, and Ashworth Scale scores were assessed.
Main Results:
- Children with CP and measurable spasticity exhibited slower peak knee angular velocity during walking compared to those without spasticity (P<.005).
- A strong significant correlation was found between spastic threshold velocity and peak knee angular velocity during fast walking (r=.85, P<.001).
- Spastic threshold velocity showed a significant correlation with GMFM scores (r=.58, P<.05) but not with Ashworth Scale scores.
Conclusions:
- Velocity-dependent spasticity can be quantitatively measured using electromyography and dynamometry to determine spastic threshold velocity.
- Spastic threshold velocity is a significant correlate of limitations in joint angular velocity during walking and overall functional performance in children with CP.
Objectives:
To evaluate a quantitative, velocity-based assessment of spasticity in the quadriceps and hamstrings muscles of children with cerebral palsy (CP) and to show the effects of spasticity in constraining knee velocities during fast gait.
Design:
A quantitative comparison of neuromuscular and biomechanical performance in patients with CP and controls without CP.
Setting:
Movement analysis laboratory within a university clinical referral center.
Participants:
A convenience sample of 18 ambulatory patients with CP and 11 control subjects without CP.
Interventions:
Not applicable.
Main Outcome Measures:
Spastic threshold velocity recorded from electromyographic response during passive isovelocity knee movement was compared with knee angular velocity during fast walking, Gross Motor Function Measure (GMFM) scores, and Ashworth Scale score.
Results:
Patients with measurable spasticity showed slower peak knee angular velocity during walking than patients without spasticity (P<.005). A significant correlation existed between spastic threshold velocity and peak knee angular velocity during fast walking (r=.85, P<.001). Spastic threshold velocity correlated significantly with GMFM (r=.58, P<.05) but not with Ashworth score.
Conclusions:
The velocity dependency of spasticity can be measured by electromyograph and dynamometer to determine spastic threshold velocity. Spastic threshold velocity correlated with limitations in joint angular velocity during walking and functional performance.
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