Related Experiment Video
Updated: May 23, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Spastic cerebral palsy in children: dynamic sonoelastographic findings of medial gastrocnemius
Dong Rak Kwon1, Gi Young Park, Sung Uk Lee
1Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, 3056-6 Daemyung 4-Dong, Nam-Gu, Daegu 705-718, South Korea.
Insights
Dynamic sonoelastography revealed increased medial gastrocnemius (GCM) stiffness in children with spastic cerebral palsy. This imaging technique differentiates muscle elasticity in pediatric cerebral palsy patients.
Area of Science:
- Biomedical Engineering
- Pediatric Neurology
- Musculoskeletal Imaging
Background:
- Spastic cerebral palsy (CP) is a common childhood motor disorder.
- Muscle spasticity in CP affects muscle elastic properties.
- Accurate assessment of muscle elasticity is crucial for understanding CP pathophysiology.
Purpose of the Study:
- To investigate the elastic properties of the medial gastrocnemius (GCM) muscle in children diagnosed with spastic cerebral palsy.
- To compare GCM elasticity between children with spastic CP and healthy controls.
Main Methods:
- Utilized dynamic sonoelastography (DS) and acoustic radiation force impulse (ARFI) imaging to assess GCM elasticity.
- Measured GCM thickness, calculated GCM ratio, and analyzed color histogram and strain ratio.
- Correlated DS parameters with Modified Ashworth Scale scores.
Main Results:
- Children with spastic CP exhibited significantly higher GCM stiffness (higher DS score, more red pixels) compared to controls.
- Lower GCM ratio and strain ratio were observed in the spastic CP group.
- Higher local shear wave velocity in GCM was noted in children with spastic CP.
Conclusions:
- Dynamic sonoelastography effectively differentiates muscle stiffness in the GCM of children with spastic cerebral palsy.
- DS provides a quantitative measure of GCM elasticity, aiding in the assessment of spasticity in pediatric CP.
Purpose:
To study the elastic properties of the medial gastrocnemius (GCM) in children with spastic cerebral palsy.
Materials And Methods:
The study protocol was approved by the Research Ethics Committee of the hospital, and informed consent was obtained from each child's parent. Fifteen children with spastic cerebral palsy (group 1) and 13 children without neurologic and musculoskeletal disabilities (group 2) were included. Because group 1 included three children with hemiplegia, the total number of legs examined was 27. Children in group 2 had both legs examined, for a total of 26 legs studied. The modified Ashworth scale score of the ankle in group 1 was assessed by a physical therapist. A physiatrist performed ultrasonography and dynamic sonoelastography (DS) together, measured the thickness of the GCM, and calculated the GCM ratio in both groups. On color-scaled DS images, the DS score of the GCM was graded from DS 1 (purple to green: soft) to DS 4 (red: stiff), and the color histogram of the GCM was subsequently analyzed. Strain ratio and local shear wave velocity were calculated in the GCM and the soleus muscle by using acoustic radiation force impulse imaging.
Results:
The GCM ratio in group 1 was significantly smaller than that in group 2. The DS score of GCM in group 1 was significantly higher than that in group 2. The median red pixel values were significantly higher, and the blue pixel values were significantly lower on color histogram in group 1 than those in group 2. The strain ratio in group 1 was significantly lower than that in group 2, and the local shear wave velocity of GCM in group 1 was higher than that in group 2. There were significant correlations between the modified Ashworth scale scores and DS parameters.
Conclusion:
DS demonstrated a difference in muscle stiffness in the GCM between children with spastic cerebral palsy and those without neurologic and musculoskeletal disabilities.
