Muscle morphology of the lower leg in ambulant children with spastic cerebral palsy

Area of Science:

• Biomedical Engineering
• Orthopedics
• Pediatric Neurology

Background:

• Spastic cerebral palsy (CP) affects motor function in children.
• Lower limb muscle morphology differences between children with CP and typically developing (TD) children are not fully understood.
• Understanding these differences is crucial for targeted interventions.

Purpose of the Study:

• To compare lower limb skeletal muscle morphology in ambulant children with spastic CP and TD children.
• To identify specific morphological characteristics of the triceps surae muscle in children with CP.
• To investigate the relationship between Gross Motor Function Classification System (GMFCS) levels and muscle morphology.

Main Methods:

• T1-weighted MRI scans of the lower limbs were performed on 17 children with spastic diplegic CP (GMFCS I-II) and 19 TD children.
• Digital quantification of triceps surae muscle volume, anatomical cross-sectional area, muscle length, and subcutaneous adipose tissue.
• Calculation of proportional distribution of muscle and fat tissues.

Main Results:

• Children with CP, especially GMFCS level II, exhibited significantly reduced muscle volume, cross-sectional area, and muscle length compared to TD children.
• Increased subcutaneous adipose tissue was observed in children with CP compared to TD children.
• GMFCS II classification was associated with the most pronounced deficits in all measured muscle morphology variables.

Conclusions:

• Significant differences in lower limb muscle morphology exist between children with spastic CP and TD children.
• These morphological alterations in the triceps surae muscle have the potential to influence functional capabilities.
• Findings highlight the need for further research into functional implications and therapeutic strategies for CP.