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Published on: February 2, 2024
Muscle growth is reduced in 15-month-old children with cerebral palsy
Anna Herskind1, Anina Ritterband-Rosenbaum2, Maria Willerslev-Olsen2
1Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
Insights
Muscle growth in children with cerebral palsy (CP) slows significantly around 15 months, unlike bone growth. This impaired muscle development may lead to contractures, highlighting the need for early interventions.
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
- Neuromuscular Disorders
Background:
- Contractures in children with cerebral palsy (CP) may stem from muscle growth lagging behind bone growth.
- Understanding muscle development patterns in CP is crucial for early intervention strategies.
Purpose of the Study:
- To compare the growth of the medial gastrocnemius muscle in children with and without CP using ultrasonography.
- To identify the age at which muscle growth deviates in children with CP compared to typically developing peers.
Main Methods:
- Utilized serial, transverse, two-dimensional ultrasonography to measure medial gastrocnemius muscle volume.
- Included 26 children with spastic CP (GMFCS levels I-III) and 101 typically developing children.
- Analyzed muscle volume changes in relation to chronological age.
Main Results:
- Medial gastrocnemius muscle volume increased linearly with age in typically developing children.
- Children with CP showed reduced muscle volume increase compared to controls, deviating significantly at 15 months (p<0.05).
- Bone length increased similarly in both groups, with no significant difference (p=0.49).
Conclusions:
- Muscle growth in children with CP initially parallels typically developing children but decelerates around 15 months.
- This growth pattern deviation may be linked to reduced physical activity and neural activation.
- Early interventions aimed at stimulating muscle growth in young children with CP are recommended to prevent contractures.
Aim:
Lack of muscle growth relative to bone growth may be responsible for development of contractures in children with cerebral palsy (CP). Here, we used ultrasonography to compare growth of the medial gastrocnemius muscle in children with and without CP.
Method:
Twenty-six children with spastic CP (15 males, 11 females; mean age 35mo, range 8-65mo) and 101 typically developing children (47 males, 54 females; mean age 29mo, range 1-69mo) were included. Functional abilities of children with CP equalled levels I to III in the Gross Motor Function Classification System. Medial gastrocnemius muscle volume was constructed from serial, transverse, two-dimensional ultrasonography images.
Results:
In typically developing children, medial gastrocnemius volume increased linearly with age. Among children with CP, medial gastrocnemius volume increased less with age and deviated significantly from typically developing children at 15 months of age (p<0.05). Bone length increased with age without significant difference (p=0.49).
Interpretation:
Muscle growth in children with CP initially follows that of typically developing children, but decreases at 15 months of age. This may be related to reduced physical activity and neural activation of the muscle. Interventions stimulating muscle growth in young children with CP may be important to prevent contractures.
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