Muscle growth is reduced in 15‐month‐old children with cerebral palsy

Abstract

Aim Lack of muscle growth relative to bone growth may be responsible for development of contractures in children with cerebral palsy (CP). Here, we used ultrasonography to compare growth of the medial gastrocnemius muscle in children with and without CP. Method Twenty‐six children with spastic CP (15 males, 11 females; mean age 35mo, range 8–65mo) and 101 typically developing children (47 males, 54 females; mean age 29mo, range 1–69mo) were included. Functional abilities of children with CP equalled levels I to III in the Gross Motor Function Classification System. Medial gastrocnemius muscle volume was constructed from serial, transverse, two‐dimensional ultrasonography images. Results In typically developing children, medial gastrocnemius volume increased linearly with age. Among children with CP, medial gastrocnemius volume increased less with age and deviated significantly from typically developing children at 15 months of age (p<0.05). Bone length increased with age without significant difference (p=0.49). Interpretation Muscle growth in children with CP initially follows that of typically developing children, but decreases at 15 months of age. This may be related to reduced physical activity and neural activation of the muscle. Interventions stimulating muscle growth in young children with CP may be important to prevent contractures.

Knee Moment-Angle Characteristics and Semitendinosus Muscle Morphology in Children with Spastic Paresis Selected for Medial Hamstring Lengthening

“…A reduced PCSA would decrease, rather than increase muscle stiffness. The substantially lower PCSA may be explained by a smaller cross-sectional area of muscle fibers (fCSA) or a lower number of muscle fibers in SP [50, 51]. Using ST biopsies, fCSA was shown to be 32% lower in children with SP compared to TD children [52].…”

The impact of strength training on skeletal muscle morphology and architecture in children and adolescents with spastic cerebral palsy: A systematic review

“…Increases in muscle size following strength training may also influence the mechanical properties of the musculotendinous unit. Specific strength training modes lead to muscle growth patterns via preferential increases in muscle fascicle pennation angle (concentric load) versus muscle fascicle length (eccentric load) in TD adults (Franchi et al, 2014), which may have implications for increasing joint range of motion and/or reducing contracture in individuals with CP (Herskind et al, 2015;Willerslev-Olsen, Lorentzen, & Nielsen, 2014).…”

Forearm Flexor Muscles in Children with Cerebral Palsy Are Weak, Thin and Stiff

“…Recent reports have highlighted stunted growth in the lower limb as a contributing factor to contracture development (Gough and Shortland, 2012) and slowed growth rate has been detected as early as 15-months of age (Herskind et al, 2015). Several investigators have described increased passive stiffness of the calf muscle in children with CP and different tests have shown that the calf muscle is 22–120% stiffer in CP children compared to TD (Ross et al, 2011; de Gooijer-van de Groep et al, 2013; Geertsen et al, 2015).…”