Upper and lower limb muscle stiffness in children with cerebral palsy compared to typically developing children:
Dolors Casellas-Vidal1, Raquel Font-Lladó2, Inés Osiniri3
1Servei de Pediatria, Hospital Universitari Doctor Josep Trueta, Girona, Spain; Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain.
Insights
Shear wave elastography (SWE) reveals distinct muscle elasticity differences in children with spastic cerebral palsy (CP) compared to typically developing children. This non-invasive technique may improve spasticity assessment by accounting for neurological and muscle factors.
Area of Science:
- Biomedical Engineering
- Pediatric Neurology
- Rehabilitation Science
Background:
- Children with spastic cerebral palsy (CP) exhibit altered muscle tone, traditionally assessed via clinical scales.
- Shear wave elastography (SWE) provides a non-invasive method to quantify muscle biomechanical properties.
Purpose of the Study:
- Compare SWE measurements in spastic CP and typically developing (TD) children.
- Investigate factors influencing SWE, including joint position, range of motion, and CP characteristics.
- Correlate SWE measurements with clinical spasticity scales in CP.
Main Methods:
- SWE measured muscle elastic modulus in upper and lower limb muscles at rest and during maximum passive stretching.
- Participants included 34 spastic CP children and 44 TD children.
- Muscles assessed: biceps brachii, pronator teres, adductor longus, lateral gastrocnemius, and soleus.
Main Results:
- Significant differences in SWE were observed between CP and TD children (p < 0.05).
- CP children showed lower upper limb and higher lower limb muscle elasticity at rest, reversing during stretching.
- Muscle elasticity correlated with Ashworth and Tardieu scales in lower limb muscles at rest.
Conclusions:
- SWE detects unique muscle elasticity patterns in spastic CP, influenced by neurological and muscle architecture factors.
- SWE may offer a more precise spasticity assessment, potentially minimizing confounding joint structure effects.
- Findings highlight the complex interplay of factors affecting muscle tone in pediatric CP.
Abstract:
Children with spastic cerebral palsy (CP) experience altered muscle tone due to biomechanical changes, traditionally assessed through clinical scales. Shear wave elastography (SWE) offers a non-invasive way to quantify these changes. This study aimed to compare SWE measurements in spastic CP and typically developing (TD) children and investigate influencing factors such as joint position, range of motion, demographics, physical condition and, in CP children, the characteristics of CP. It also examined correlations between SWE measurements and spasticity scales in CP children. SWE measured the elastic modulus (kPa) of biceps brachii (BB), pronator teres (PT), adductor longus (AL), lateral gastrocnemius (LG), and soleus (SOL) muscles at rest and during maximum passive stretching (MPS) in 34 spastic CP children (age: 3-17) and 44 TD children (age: 3-14). Significant differences (p < 0.05) in SWE were found between CP and TD children. CP children had lower values in upper limb muscles and higher values in lower limb muscles at rest, with the opposite pattern during MPS. The Ashworth and Tardieu scales were associated with the elastic modulus in lower limb muscles (AL, GL, and SOL) at rest in CP children. Differences in elastic modulus at rest and MPS between upper and lower limbs and in spastic CP and TD children showed no consistent links to spasticity scales, reflecting neurological dysregulation, muscle architecture, and joint structure involvement. These variations were linked to neurological dysregulation and muscle architecture, with joint structures also affecting. SWE may offer a more precise assessment of muscle spasticity, minimizing the impact of confounding joint structures.
Related Concept Videos
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:27Signs of Puberty
01:23Guidelines for Sketching a Curve