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Lower-extremity strength profiles in spastic cerebral palsy
1Curry School of Education, University of Virginia, Charlottesville, USA.
Insights
Children with cerebral palsy (CP) exhibit significant lower-extremity weakness and muscle imbalances across joints. This study quantifies this weakness in multiple muscle groups, highlighting its impact on daily mobility.
Area of Science:
- Neurology
- Orthopedics
- Pediatrics
Background:
- Cerebral palsy (CP) is associated with muscle weakness, but comprehensive documentation across multiple muscle groups and joints is lacking.
- Understanding the patterns of weakness is crucial for targeted interventions in children with CP.
Purpose of the Study:
- To quantify the magnitude and patterns of lower-extremity muscle weakness in children with spastic diplegia and spastic hemiplegia.
- To compare muscle strength across joints in children with CP to age-matched peers.
Main Methods:
- Maximum voluntary contraction of eight lower extremity muscle groups was measured using a hand-held dynamometer.
- Participants included children with spastic diplegia, spastic hemiplegia, and typically developing controls.
Main Results:
- Children with spastic CP showed weakness in all tested lower extremity muscles compared to controls.
- Weakness was more pronounced distally, with altered strength ratios observed in hip flexors and ankle plantarflexors.
- Even the uninvolved side in hemiplegic CP demonstrated strength differences.
Conclusions:
- Children with spastic cerebral palsy have quantifiable lower-extremity weakness.
- Significant muscle imbalances across joints are present in children with spastic CP.
- Findings underscore the need for comprehensive strength assessment and tailored rehabilitation strategies.
Abstract:
Although weakness has been identified in cerebral palsy (CP) in isolated muscle groups, the magnitude of weakness in multiple muscles and the patterns of weakness across joints have not been documented. The maximum voluntary contraction of eight muscle groups in the lower extremities of 15 children with spastic diplegia, 15 with spastic hemiplegia, and 16 age-matched peers was determined using a hand-held dynamometer. Children with spastic diplegia were shown to be weaker than age-matched peers in all muscles tested, as were the children with hemiplegia on the involved side, with strength differences also noted on the uninvolved side. Weakness was more pronounced distally in the groups with CP, and the hip flexors and ankle plantarflexors in spastic CP tended to be relatively stronger than their antagonists as compared with the strength ratios of the comparison group. In conclusion, children with spastic CP demonstrate quantifiable lower-extremity weakness and muscle imbalance across joints.