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Published on: November 27, 2017
Estimation of gastrocnemius muscle volume using ultrasonography in children with spastic cerebral palsy
Eun Sook Park1, Eungeol Sim1, Dong-Wook Rha1
1Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
Ultrasonography and anthropometry can estimate gastrocnemius muscle volume in children with spastic cerebral palsy. Anatomical cross-sectional area is a more useful parameter than muscle thickness for these estimations.
Area of Science:
- Biomedical Engineering
- Pediatric Rehabilitation
- Musculoskeletal Ultrasound
Background:
- Spastic cerebral palsy (CP) often affects lower limb musculature, impacting motor function.
- Accurate assessment of gastrocnemius muscle volume (MV) is crucial for understanding muscle changes in CP.
- Non-invasive methods are needed to complement traditional imaging like MRI.
Purpose of the Study:
- To identify reliable parameters for estimating gastrocnemius muscle volume (MV) in children with spastic CP.
- To evaluate the utility of ultrasonography (US) and anthropometry for MV estimation.
- To compare the predictive value of muscle thickness (MT) and anatomical cross-sectional area (aCSA) for GCM MV.
Main Methods:
- Investigated 18 legs from 9 children (aged 2-6 years) with spastic CP.
- Measured tibial length (TL) and used US to assess GCM muscle thickness (MT) and anatomical cross-sectional area (aCSA).
- Compared US-derived parameters and TL with GCM MV measured by MRI, using regression analyses.
Main Results:
- Resting MT, aCSA, and TL showed strong correlations with GCM MV (r² from 0.591 to 0.903).
- aCSA demonstrated higher predictive accuracy for MV than MT.
- Multiple regression models yielded higher r² values but with significant standard errors (15.5-25.6%).
Conclusions:
- Ultrasonography assessment of aCSA and MT, combined with TL, is suitable for estimating GCM MV in children with spastic CP.
- aCSA is a more valuable parameter than MT for predicting GCM MV in this population.
- US offers a practical alternative for GCM MV assessment in pediatric CP.
Purpose:
This study aimed to investigate useful parameters for estimating gastrocnemius (GCM) muscle volume (MV) using ultrasonography (US) and anthropometry in children with spastic cerebral palsy (CP).
Materials And Methods:
Eighteen legs from nine children with spastic CP aged 2 to 6 years were investigated in this study. Tibial length (TL) of each leg was measured and muscle thickness (MT) and anatomical cross-sectional area (aCSA) of GCM muscles were assessed using US. The volume of the GCM was measured by magnetic resonance imaging (MRI) scans. The relationship of TL, MT, and aCSA with MV measured by MRI was investigated. Simple and multiple regression analyses were performed to establish muscle volume prediction equations.
Results:
Resting MT, aCSA, and TL were highly related to MV of both medial and lateral head of GCM determined by MRI. The MV prediction equation based on simple regression analysis resulted in r² values ranging from 0.591 to 0.832 (p<0.05). The r² values were higher using aCSA as independent variable than using MT. The MV prediction equation based on multiple regression analysis resulted in r² values ranging from 0.779 to 0.903 (p<0.05). However, the relatively high standard error of the estimate values ranged from 18.0-33.6% on simple regression and 15.5-25.6% on multiple regression. The contribution of aCSA was higher than that of MT for predicting MV of GCM.
Conclusion:
Our study demonstrated the suitability of US assessment of aCSA and MT combined with TL for estimating MV of GCM in children with spastic CP and showed that aCSA is more useful parameter than MT.
