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Open Access Dynamic spasticity of plantar flexor muscles in cerebral palsy gait

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Objective: To quantify dynamic spasticity, i.e. the coupling between muscle-tendon stretch velocity and muscle activity during gait, of the gastrocnemius and soleus muscles in children with spastic cerebral palsy.

Design: Prospective, cross-sectional study.

Subjects: Seventeen ambulatory children with cerebral palsy with spastic calf muscles, and 11 matched typically developing children.

Methods: The children walked at 3 different speeds. Three-dimensional kinematic and electromyographic data were collected. Muscle-tendon velocities of the gastrocnemius medialis and soleus were calculated using musculoskeletal modelling.

Results: In typically developing children, muscles were stretched fast in swing without subsequent muscle activity, while spastic muscles were stretched more slowly for the same walking speed, followed by an increase in muscle activity. The mean ratio between peak activity and peak stretch velocity in swing was approximately 4 times higher in spastic muscles, and increased with walking speed. In stance, the stretch of muscles in typically developing children was followed by an increase in muscle activity. Spastic muscles were stretched fast in loading response, but since muscle activity was already built up in swing, no clear dynamic spasticity effect was present.

Conclusion: Spastic calf muscles showed increased coupling between muscle-tendon stretch velocity and muscle activity, especially during the swing phase of gait.

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Keywords: BIOMECHANICS; CEREBRAL PALSY; GAIT; SPASTICITY

Document Type: Research Article

Publication date: 01 July 2010

More about this publication?
  • Journal of Rehabilitation Medicine is the international peer-reviewed journal published in English, with at least 10 issues published per year.

    Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.

    The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.

    Contributions from all parts of the world and from different professions in rehabilitation are welcome.

    ISI Impact Factor 2009: 1.882.

    Owned by Foundation of Rehabilitation Information.

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