Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

Bruin, M. de; Veeger, H.E.J.; Kreulen, M.; Smeulders, M.J.C.; Bus, Sicco A.

doi:10.1016/j.jelekin.2012.10.013

Cited by 13 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This task requires the execution of elbow extension combined with supination which is particularly challenging for children with uCP, due to the impairing role of the biceps brachii muscle. Over-activity of this muscle impairs elbow extension, and simultaneously enforces elbow supination to assist the weakened supinator muscles in overcoming pronation forces [21,22]. The resulting limited ROM of elbow supination and extension further prevents proper placing of the hand around the cylinder leading to proximal compensations [21,22].…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

et al. 2017

View full text Add to dashboard Cite

IntroductionThe clinical application of upper limb (UL) three-dimensional movement analysis (3DMA) in children with unilateral cerebral palsy (uCP) remains challenging, despite its benefits compared to conventional clinical scales. Moreover, knowledge on UL movement pathology and how this relates to clinical parameters remains scarce. Therefore, we investigated UL kinematics across different manual ability classification system (MACS) levels and explored the relation between clinical and kinematic parameters in children with uCP.Patients and methodsFifty children (MACS: I = 15, II = 26, III = 9) underwent an UL evaluation of sensorimotor impairments (grip force, muscle strength, muscle tone, two-point discrimination, stereognosis), bimanual performance (Assisting Hand Assessment, AHA), unimanual capacity (Melbourne Assessment 2, MA2) and UL-3DMA during hand-to-head, hand-to-mouth and reach-to-grasp tasks. Global parameters (Arm Profile Score (APS), duration, (timing of) maximum velocity, trajectory straightness) and joint specific parameters (angles at task endpoint, ROM and Arm Variable Scores (AVS)) were extracted. The APS and AVS refer respectively to the total amount of movement pathology and movement deviations of wrist, elbow, shoulder, scapula and trunk.ResultsLonger movement durations and increased APS were found with higher MACS-levels (p<0.001). Increased APS was also associated with more severe sensorimotor impairments (r = -0.30-(-0.73)) and with lower AHA and MA2-scores (r = -0.50-(-0.86)). For the joint specific parameters, stronger movement deviations distally were significantly associated with increased muscle weakness (r = -0.32-(-0.74)) and muscle tone (r = 0.33-(-0.61)); proximal movement deviations correlated only with muscle weakness (r = -0.35–0.59). Regression analysis exposed grip force as the most important predictor for the variability in APS (p<0.002).ConclusionWe found increased movement pathology with increasing MACS-levels and demonstrated the adverse impact of especially muscle weakness. The lower correlations suggest that 3DMA provides additional information regarding UL motor function, particularly for the proximal joints. Integrating both methods seems clinically meaningful to obtain a comprehensive representation of all aspects of a child’s UL functioning.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

et al. 2017

View full text Add to dashboard Cite

show abstract

“…8 BB activation in children with spastic hemiparesis CP and healthy children was lower during reach-to-grasp tasks requiring forearm pronation than during tasks that required supination. 15 During the kinematics comparison, our hypothesis that a smaller ROM would be observed in the intragroup comparisons of the shoulder, forearm, and wrist was confirmed. We noted an interaction between groups and phases.…”

Section: Discussionmentioning

confidence: 66%

“…12 It is suggested that physiological actions such as co-contraction, involuntary activation of the antagonist muscles, and overflow of the electromyographic activity (EMG) of muscles not involved in voluntary movement, as well as the sum of these changes, cause movement dysfunction during the tasks performed by patients with DCP. 14 However, upper limb function can be considered neglected in the literature to some extent, except for a few studies on spastic 12 and hemiparetic CP, 15 functional activity, 16 movements of more than one joint, 17 and simultaneous EMG activities of the proximal and distal muscles. 14 However, upper limb function can be considered neglected in the literature to some extent, except for a few studies on spastic 12 and hemiparetic CP, 15 functional activity, 16 movements of more than one joint, 17 and simultaneous EMG activities of the proximal and distal muscles.…”

mentioning

confidence: 99%

“…13 Movement analysis through the study of kinematics focuses on the lower limbs and provides a comprehensive understanding of the locomotion of patients with CP. 14 However, upper limb function can be considered neglected in the literature to some extent, except for a few studies on spastic 12 and hemiparetic CP, 15 functional activity, 16 movements of more than one joint, 17 and simultaneous EMG activities of the proximal and distal muscles. 18 Only one study to date has evaluated the drinking task in adult patients with DCP, characterizing it as less smooth, slow, and with a reduced range of motion (ROM) of the shoulder and elbow joints compared to that in healthy adults.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Adult dyskinetic cerebral palsy: Upper limb movement and muscle function

et al. 2019

View full text Add to dashboard Cite

Cerebral palsy (CP) is a term used to classify individuals with nonprogressive lesions of the immature brain and consequent movement difficulty and postural instability. 1 CP is the most prevalent cause of chronic motor function impairment. 2 Patients with CP are categorized by movement disorder type, which may be spastic, dyskinetic (dystonia or choreoathetosis), or ataxic. The degree of functional impairment varies, depending on a combination of type, topography of motor dysfunction, and severity. 2 Although clinical changes are not progressive, the health care of individuals with CP should be continuous because their motor function may decline throughout their lives. The average lifetime cost for an individual with CP, including medical, non-medical, and special education expenses, is $1.2 million. 3 Scientific evidence of interventions for maintaining physical function and mobility is limited, and the existing studies are usually of low methodological quality. 4 The same is true for treatments for muscle tone changes in dystonia of adults with CP. 5 This implies a gap in the literature on the natural history of the disease as well as the quality and cost-effectiveness of the interventions, 6 especially in the adult population. 7Spastic CP is the most prevalent and widely studied type. 8 However, dyskinetic CP (DCP) also has a high prevalence (15%-20%) 9in the total population with the disease, affecting one in 500 newborns and 17 million people worldwide. 6 DCP is less well studied Aim: The aim of this study was to characterize upper-limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. Method: Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG)participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return.Results: Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. Interpretation:The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.

show abstract

“…Braendvik et al [34] demonstrated that spasticity, measured as involuntary biceps brachii activation during passive elbow extension, contributes to limitations in upper limb activity in children with CP. Bruin et al [35] also confirmed a connection between increased biceps brachii involuntary activation and the decrease of upper limb activity. Based on their conclusion, the relationship between the ability to voluntarily activate a muscle and activity performance explains how spasticity can contribute to the limitations of daily living activities.…”

Section: Discussionmentioning

confidence: 87%

Effects of tDCS on Muscle Stiffness in Children with Cerebral Palsy Measured by Myotonometry: A Preliminary Study

Smoter¹,

Jędrzejczyk-Góral²,

Chen

et al. 2020

Applied Sciences

View full text Add to dashboard Cite

Background: The aim of this study was to investigate the influence of transcranial direct current stimulation (tDCS) on the biceps brachii and flexor carpi radialis stiffness in children with cerebral palsy (CP). The authors also aimed to verify the relationship between spasticity and muscle stiffness. Methods: Twelve children with CP (mean ± SD; age, 8 ± 1.3 years; height, 118.7 ± 4.1 cm; weight, 23.0 ± 2.2 kg) were involved in the study. Muscle stiffness was estimated using a MyotonPRO device in a MultiScan pattern of five measurements. Simultaneously, the tDCS stimulation was performed. Spasticity was assessed by a neurologist using the Ashworth Scale. Results: Stiffness of the flexor carpi radialis muscle decreased significantly after tDCS therapy (p = 0.04). There was no significant change in stiffness of the biceps brachii. For all participants, the Spearman rank correlation showed statistically significant and positive relationships between muscle stiffness and the Ashworth Scale (p = 0.04). Conclusions: Transcranial direct current stimulation has a decreasing effect on stiffness and spasticity of the flexor carpi radialis in children with CP. The MyotonPRO device provides objective data and correlates with spasticity measurements.

show abstract

Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

Cited by 13 publications

References 28 publications

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

Adult dyskinetic cerebral palsy: Upper limb movement and muscle function

Effects of tDCS on Muscle Stiffness in Children with Cerebral Palsy Measured by Myotonometry: A Preliminary Study

Contact Info

Product

Resources

About