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Relationship between age and spasticity in children with diplegic cerebral palsy

Samuel R Pierce1, Laura A Prosser, Richard T Lauer

  • 1Shriners Hospitals for Children, Philadelphia, PA, USA. srpierce@mail.widener.edu

Archives of Physical Medicine and Rehabilitation
|March 20, 2010
PubMed

Insights

As children with spastic diplegic cerebral palsy (CP) age, passive stiffness becomes a more significant factor in knee spasticity than reflex activity. This finding may impact future treatment strategies for CP.

Area of Science:

  • Pediatric Orthopedics
  • Neurology
  • Rehabilitation Medicine

Background:

  • Spasticity in children with spastic diplegic cerebral palsy (CP) affects motor function.
  • Understanding the factors contributing to spasticity, such as passive torque, reflex activity, and co-contraction, is crucial for effective management.
  • Age-related changes in these factors during development are not fully elucidated.

Purpose of the Study:

  • To investigate the relationship between passive torque, reflex activity, co-contraction, and age in children with spastic diplegic CP.
  • To assess how these parameters change with age in the knee flexors and extensors.
  • To inform potential age-dependent therapeutic interventions for spasticity in CP.

Main Methods:

  • A retrospective study was conducted involving 36 children with spastic diplegic CP.
  • Spasticity of knee flexors and extensors was measured using an isokinetic dynamometer and electromyography.
  • Key metrics included peak and mean passive torque, medial hamstring and vastus lateralis reflex activity, and co-contraction during passive movements.

Main Results:

  • A significant positive correlation was observed between increasing age and mean knee flexor passive torque (P<.05).
  • A significant negative correlation was found between age and the mean percentage of range of motion with co-contraction (P<.05).
  • Reflex activity did not show a significant relationship with age in this cohort.

Conclusions:

  • Passive stiffness appears to be a more dominant factor in knee spasticity than reflex activity as children with spastic diplegic CP grow older.
  • These age-related changes suggest that interventions targeting passive stiffness may become more critical with age.
  • Further research is warranted to explore how age influences the efficacy of interventions like serial casting and botulinum toxin for managing spasticity in CP.
Abstract

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