Muscle size, activation, and coactivation in adults with cerebral palsy

Introduction: Muscle weakness is present in the paretic limbs of individuals with cerebral palsy (CP). We aimed to determine what neuromuscular factors contribute to weakness in adults with CP during isometric maximal voluntary contractions (iMVCs). Methods: Gastrocnemius anatomical cross‐sectional area (ACSA) and agonist and antagonist activation were measured in 11 CP and 11 control adult men during plantarflexion iMVC. Results: Plantarflexion iMVC torque of the paretic leg was 42% and 52% less than in the non‐paretic and control limbs, respectively. The paretic gastrocnemius ACSA was smaller than in the control group only. Paretic agonist activation was less than the non‐paretic and control groups, whereas antagonist coactivation was higher. Multiple regression analysis revealed muscle activation accounted for 57% of variation in paretic plantarflexion iMVC torque. Conclusions: In individuals with CP, muscle weakness in the paretic limb is attributed primarily to impaired neural activation and, to a lesser degree, ACSA. Muscle Nerve 49: 76–83, 2014

[1]  R. Barrett,et al.  Medial gastrocnemius muscle fascicle active torque-length and Achilles tendon properties in young adults with spastic cerebral palsy. , 2012, Journal of biomechanics.

[2]  Vasilios Baltzopoulos,et al.  In vivo measurements of muscle specific tension in adults and children , 2010, Experimental physiology.

[3]  Adam P Shortland,et al.  Increases in muscle volume after plantarflexor strength training in children with spastic cerebral palsy , 2009, Developmental medicine and child neurology.

[4]  S. Hanna,et al.  Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years , 2009, Developmental medicine and child neurology.

[5]  T. Takken,et al.  Reliability of hand-held dynamometry and functional strength tests for the lower extremity in children with Cerebral Palsy , 2008, Disability and rehabilitation.

[6]  Adam P Shortland,et al.  The morphology of the medial gastrocnemius in typically developing children and children with spastic hemiplegic cerebral palsy. , 2007, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[7]  Vasilios Baltzopoulos,et al.  Differences in gastrocnemius muscle architecture between the paretic and non-paretic legs in children with hemiplegic cerebral palsy. , 2007, Clinical biomechanics.

[8]  C. Maganaris,et al.  Muscle activation assessment: Effects of method, stimulus number, and joint angle , 2006, Muscle & nerve.

[9]  Stuart A Binder-Macleod,et al.  Voluntary muscle activation, contractile properties, and fatigability in children with and without cerebral palsy , 2005, Muscle & nerve.

[10]  Richard L Lieber,et al.  Structural and functional changes in spastic skeletal muscle , 2004, Muscle & nerve.

[11]  Marco V. Narici,et al.  Reduced plantarflexor specific torque in the elderly is associated with a lower activation capacity , 2004, European Journal of Applied Physiology.

[12]  H. Graham,et al.  A randomized clinical trial of strength training in young people with cerebral palsy. , 2003, Developmental medicine and child neurology.

[13]  R. Lieber,et al.  Inferior mechanical properties of spastic muscle bundles due to hypertrophic but compromised extracellular matrix material , 2003, Muscle & nerve.

[14]  L. Leahey,et al.  Contributing factors to muscle weakness in children with cerebral palsy , 2003, Developmental medicine and child neurology.

[15]  E. Mattsson,et al.  Adults with cerebral palsy: walking ability after progressive strength training , 2003, Developmental medicine and child neurology.

[16]  P. Selber,et al.  Musculoskeletal aspects of cerebral palsy. , 2003, The Journal of bone and joint surgery. British volume.

[17]  R. Shepherd,et al.  Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4–8 years , 2003, Clinical rehabilitation.

[18]  A. Macaluso,et al.  Contractile muscle volume and agonist‐antagonist coactivation account for differences in torque between young and older women , 2002, Muscle & nerve.

[19]  M. Abel,et al.  Spasticity versus strength in cerebral palsy: relationships among involuntary resistance, voluntary torque, and motor function , 2001, European journal of neurology.

[20]  C. Rice,et al.  Normalized force, activation, and coactivation in the arm muscles of young and old men. , 2001, Journal of applied physiology.

[21]  E. Simonsen,et al.  A mechanism for increased contractile strength of human pennate muscle in response to strength training: changes in muscle architecture , 2001, The Journal of physiology.

[22]  M. Urbanchek,et al.  Specific force deficit in skeletal muscles of old rats is partially explained by the existence of denervated muscle fibers. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[23]  Samuel C. K. Lee,et al.  Measurement of central activation failure of the quadriceps femoris in healthy adults , 2000, Muscle & nerve.

[24]  Vasilios Baltzopoulos,et al.  In vivo measurement-based estimations of the human Achilles tendon moment arm , 2000, European Journal of Applied Physiology.

[25]  K P Granata,et al.  Muscle force production and functional performance in spastic cerebral palsy: relationship of cocontraction. , 2000, Archives of physical medicine and rehabilitation.

[26]  D. Ben-sira,et al.  Reliability of isokinetic strength measurements of the knee in children with cerebral palsy , 2000, Developmental medicine and child neurology.

[27]  S. Harridge,et al.  Knee extensor strength, activation, and size in very elderly people following strength training , 1999, Muscle & nerve.

[28]  W J Kraemer,et al.  Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people. , 1998, Journal of applied physiology.

[29]  K P Granata,et al.  Quantification of cocontraction in spastic cerebral palsy. , 1998, Electromyography and clinical neurophysiology.

[30]  M. Abel,et al.  Functional outcomes of strength training in spastic cerebral palsy. , 1998, Archives of physical medicine and rehabilitation.

[31]  K. Cureton,et al.  Effects of concentric and eccentric training on muscle strength, cross-sectional area, and neural activation. , 1996, Journal of applied physiology.

[32]  Kazuhiko Cho,et al.  Muscle histopathology in spastic cerebral palsy , 1996, Brain and Development.

[33]  James R. Gage,et al.  Gait Analysis: Principles and Applications , 1995 .

[34]  S C Gandevia,et al.  Reliability of measurements of muscle strength and voluntary activation using twitch interpolation , 1995, Muscle & nerve.

[35]  H. Graham,et al.  Test-retest reliability of hand-held dynamometric strength testing in young people with cerebral palsy. , 2004, Archives of physical medicine and rehabilitation.

[36]  A. Minetti,et al.  Assessment of human knee extensor muscles stress from in vivo physiological cross-sectional area and strength measurements , 2004, European Journal of Applied Physiology and Occupational Physiology.

[37]  La Koman,et al.  Seminar. Cerebral palsy , 2004 .

[38]  M. Hallett,et al.  Classification and definition of disorders causing hypertonia in childhood. , 2003, Pediatrics.

[39]  Constantinos N. Maganaris,et al.  Ultrasonographic assessment of human skeletal muscle size , 2003, European Journal of Applied Physiology.

[40]  Oded Bar-Or,et al.  Factors Influencing the Physical Activity Levels of Youths with Physical and Sensory Disabilities , 2000 .

[41]  V R Edgerton,et al.  Specific tension of human plantar flexors and dorsiflexors. , 1996, Journal of applied physiology.

[42]  J. Gage,et al.  Gait analysis: principle and applications with emphasis on its use in cerebral palsy. , 1996, Instructional course lectures.

[43]  P. Grimaud.  [Cerebral palsy]. , 1972, Pediatrie.