Medial gastrocnemius muscle volume and fascicle length in children aged 2 to 5 years with cerebral palsy

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Title Medial gastrocnemius muscle volume and fascicle length in children aged 2 to 5 years with cerebral palsy
Author Barber, Lee Anthony; Hastings-Ison, Tandy; Baker, Richard; Barrett, Rod; Lichtwark, Glen
Journal Name Developmental Medicine and Child Neurology
Year Published 2011
Place of publication United Kingdom
Publisher Mac Keith Press
Abstract Aim  The aim of this article was to compare medial gastrocnemius muscle volume, physiological cross-sectional area (PCSA), muscle length, fascicle length, and pennation angle in children aged 2 to 5 years with spastic cerebral palsy (CP) and in typically developing children. Method  Fifteen children with spastic CP (11 males, four females; mean age 45mo [SD 15mo]; five with hemiplega; 10 with diplega; 10 classified at Gross Motor Function Classification System (GMFCS) level I, five at GMFCS level II) and 20 typically developing children (11 males, nine females; mean age 48mo [SD 14mo]) participated in the study. Individuals with spastic CP were included if they had a minimum range of motion of 0° ankle dorsiflexion with the knee extended and were excluded if they had had previous botulinum toxin treatment to the calf muscles or previous calf surgery. Typically developing children were included if they were able to walk independently and were excluded if there was a history of previous lower leg injury or other developmental disorder affecting the lower limb. Freehand two-dimensional and three-dimensional ultrasound was used to assess muscle properties of the relaxed medial gastrocnemius muscle at three ankle joint angles: maximum dorsiflexion, neutral and maximum plantarflexion. PCSA was calculated as a function of muscle volume and muscle fascicle length and pennation angle was recorded at the neutral ankle joint angle. Results  Medial gastrocnemius muscle volume was 22% lower in the group with spastic CP than in the typically developing group, which in the absence of significant group differences in neutral fascicle length gave rise to an equivalent reduction in PCSA for the group with spastic CP. Significant positive correlations were found between muscle volume and age (r=0.63–0.65) and between muscle length and age (r=0.72–0.81) in both groups. Maximum ankle dorsiflexion angle was also reduced in the group with spastic CP (8°) compared with the typically developing group (26°). Interpretation  The observed reduction in muscle PCSA in the group with spastic CP would be expected to contribute to the clinically observed muscle weakness in spastic CP and suggests the need for early intervention in order to minimize loss of muscle PCSA in spastic CP.
Peer Reviewed Yes
Published Yes
Alternative URI
Volume 53
Issue Number 6
Page from 543
Page to 548
ISSN 1469-8749
Date Accessioned 2011-05-23
Language en_AU
Research Centre Centre for Musculoskeletal Research; Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject Biomechanics
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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