Morphological and Biochemical Abnormalities of Gracilis Muscle from Children with Cerebral Palsy
Vadim Evreinov1, Maksim Stogov1, Elena Kireeva1
1National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia.
Insights
Cerebral palsy (CP) patients show muscle abnormalities in the gracilis, worsening with motor impairment severity. These changes impact function and physical therapy potential, highlighting the need for targeted interventions.
Area of Science:
- Neurology
- Muscle Physiology
- Biochemistry
Background:
- Physiotherapy for Cerebral Palsy (CP) requires understanding muscle changes.
- The gracilis muscle exhibits significant morphological alterations in CP patients.
- This study investigates muscle changes related to CP severity.
Purpose of the Study:
- To analyze morphological and biochemical alterations in the gracilis muscle.
- To correlate these changes with the severity of motor impairments in CP patients.
Main Methods:
- A cross-sectional study of 24 CP patients stratified by motor impairment.
- Analysis of intraoperative gracilis muscle samples.
- Evaluation of nutritional, morphometric, and biochemical parameters.
Main Results:
- Lower body mass and Quetelet index in GMFCS V patients.
- Muscle tissue predominated in GMFCS II-III and V; connective tissue higher in GMFCS IV.
- GMFCS V patients showed more strong, anaerobic fibers with reduced creatine phosphokinase activity.
Conclusions:
- Structural and metabolic muscle abnormalities in CP indicate functional dysfunction limiting motor ability.
- Muscle alterations correlate with motor dysfunction severity.
- Less severe changes in ambulatory children suggest potential for physical therapy.
Background:
Developing an evidence base for physiotherapy programs for patients with Cerebral Palsy (CP) requires an understanding of the microscopic and metabolic processes in striated muscle. The gracilis muscle represents a logical object of study due to the significant morphological changes in individuals with cerebral palsy. This research aims to study morphological and biochemical alterations in the gracilis muscle depending on the severity of motor impairments in CP patients.
Methods:
The cross-sectional study included 24 patients stratified by the severity of motor impairment. Intraoperative gracilis muscle samples were obtained during tenomyotomies. Nutritional status of patients, morphometric, and biochemical parameters were evaluated.
Results:
Initial body mass and Quetelet index (p = 0.02) were lower in GMFCS V patients (p = 0.01) compared to GMFCS IV and GMFCS II-III. Muscle tissue predominated in histological samples of GMFCS II-III and GMFCS V patients (p = 0.79), while connective tissue content was higher in the GMFCS IV group (p = 0.03). Strong, fast-twitch, anaerobic fibers (p = 0.761) with reduced creatine phosphokinase activity (p = 0.012) were more frequently observed in the intraoperative samples of GMFCS V patients. Low creatine phosphokinase activity was revealed in children in the GMFCS V group (p = 0.012).
Conclusions:
The structural and metabolic abnormalities observed in gracilis muscle of patients with spastic cerebral palsy indicates profound functional muscular dysfunction, representing one of the factors limiting children's motor ability. The morphological and biochemical alterations in the striated muscle of CP children correlate with severity of motor dysfunction conditioned by the primary upper motor neuron disorders. Less significant changes in muscles in ambulatory children reflect favorable basis for physical therapy.
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