Temporal characteristics of lower extremity moment generation in children with cerebral palsy

Lower extremity weakness has been documented in children with cerebral palsy (CP). However, the temporal characteristics of moment generation have not been characterized, and they may be important to function. This study tested ankle, knee, and hip flexion and extension moment generation capabilities in children with CP and in able‐bodied children. Maximum voluntary isometric contractions (MVIC), the maximum rates of moment development and relaxation, and the time to produce and reduce the moments were quantified. Relationships between the temporal measures, Gross Motor Function Measure‐66 (GMFM‐66), and MVICs were also examined. Children with CP had significantly reduced MVICs, maximum development, and relaxation rates, and increased times to produce and reduce moments. The maximum rates of moment development and relaxation at some joints were correlated with the GMFM‐66 and MVICs. These results suggest that both the magnitude and temporal characteristics of moment generation need to be targeted during therapeutic interventions for children with CP. Muscle Nerve, 2008

[1]  Richard L Lieber,et al.  Spastic muscle cells are shorter and stiffer than normal cells , 2003, Muscle & nerve.

[2]  J. Rothwell,et al.  Strength in Parkinson's disease: Relationshp to rate of force generation and clinical status , 1996, Annals of neurology.

[3]  C. Luchies,et al.  The effects of motion on force control abilities. , 2001, Clinical biomechanics.

[4]  J. Rose,et al.  Muscle pathology and clinical measures of disability in children with cerebral palsy , 1994, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[5]  C. Gregory,et al.  Lower extremity skeletal muscle function in persons with incomplete spinal cord injury , 2006, Spinal Cord.

[6]  M. Orlin,et al.  Muscle Force and Range of Motion as Predictors of Standing Balance in Children with Cerebral Palsy , 2004, Physical & occupational therapy in pediatrics.

[7]  Jack R Engsberg,et al.  Relation between spasticity and strength in individuals with spastic diplegic cerebral palsy , 2002, Developmental medicine and child neurology.

[8]  T. Sanger,et al.  Abnormal coupling of knee and hip moments during maximal exertions in persons with cerebral palsy , 2003, Muscle & nerve.

[9]  Antony J Hodgson,et al.  Time and magnitude of torque generation is impaired in both arms following stroke , 2003, Muscle & nerve.

[10]  Relation between spasticity and strength in individuals with spastic diplegic cerebral palsy , 2002 .

[11]  Kevin C McGill,et al.  Neuromuscular activation and motor-unit firing characteristics in cerebral palsy. , 2005, Developmental medicine and child neurology.

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

[13]  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.

[14]  M. Abel,et al.  Deficits in eccentric versus concentric torque in children with spastic cerebral palsy. , 2001, Medicine and science in sports and exercise.

[15]  P. London.  Injury , 1969, Definitions.

[16]  C L Vaughan,et al.  MUSCLE RESPONSE TO HEAVY RESISTANCE EXERCISE IN CHILDREN WITH SPASTIC CEREBRAL PALSY , 1995, Developmental medicine and child neurology.

[17]  H. MacPhail,et al.  Relationships Among Measures of Walking Efficiency, Gross Motor Ability, and Isokinetic Strength In Adolescents With Cerebral Palsy , 1994 .

[18]  Richard W. Bohannon.  Measurement, nature, and implications of skeletal muscle strength in patients with neurological disorders. , 1995, Clinical biomechanics.

[19]  C. Reggiani,et al.  Specific contributions of various muscle fibre types to human muscle performance: an in vitro study. , 1999, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[20]  L. Ada,et al.  Slowness to develop force contributes to weakness after stroke. , 1999, Archives of Physical Medicine and Rehabilitation.

[21]  Hui-Yi Wang,et al.  Evaluating the responsiveness of 2 versions of the gross motor function measure for children with cerebral palsy. , 2006, Archives of physical medicine and rehabilitation.

[22]  A. Schultz,et al.  Biomechanical analyses of rising from a chair. , 1992, Journal of biomechanics.

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

[24]  P. Raina,et al.  Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. , 2000, Physical therapy.

[25]  J. Marques.  Lower-extremity strength profiles in spastic cerebral palsy. , 2002, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[26]  J. Engsberg,et al.  Increasing Ankle Strength to Improve Gait and Function in Children with Cerebral Palsy: A Pilot Study , 2006, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

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

[28]  J. Rose,et al.  The motor unit in cerebral palsy , 1998, Developmental medicine and child neurology.