Muscle Size, Composition, and Architecture in Cerebral Palsy

Modlesky, Christopher M.; Zhang, Chuan

doi:10.1007/978-3-319-50592-3_14-1

Cited by 3 publications

(3 citation statements)

References 86 publications

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“…In children with CP, the central input that stimulates the motor neurons of the muscles is decreased due to pyramidal tract damage, also the child is unable to activate the high-threshold motor unit groups necessary for maximum voluntary contraction [27]. Modlesky and Zhang [28] suggested that CP have smaller muscles that contain less contractile tissue and more fat, which interfere with force generation and contribute to significant muscle weakness.…”

Section: Discussionmentioning

confidence: 99%

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

et al. 2021

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Background In children with spastic diplegia, efficient use of the upper extremity especially the hands play an important role in participation in daily living. Hands can perform heavy activities and also enable to perform extremely gentle, skillful, and precise activities. Inadequate hand strength and fine motor skills may lead to functional limitations. This study was planned to investigate the pinch grip strength and fine manual control in children with spastic diplegic cerebral palsy and to determine if there is a relation between them. Thirty children with diplegic cerebral palsy and 30 normal developed children from both sexes between 5 and 10 years old were included in this study as diplegic and control groups. For all children, pinch grip strength measured by Baseline Mechanical Pinch Gauge and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition used to evaluate fine manual control. Results Children with diplegic cerebral palsy have significant impairment in the pinch grip strength (tip, tripod, and key) and the fine manual control (fine motor precision and integration) compared to their healthy peers of the same age. There was large positive significant correlation (r > 0.5, p < 0.05) between tip and tripod pinch strength, and fine motor precision and medium positive significant correlation (r = 0.47, p < 0.05) between key pinch and fine motor precision in children with spastic diplegia. Also, there was large positive significant correlation between tip pinch and fine motor integration (r = 0.54, p < 0.05). The correlations are small and medium positive between tripod and key pinch strength, and fine motor integration respectively but they are not statistically significant. Conclusions Pinch grip strength and fine manual skills are affected in children with spastic diplegia. Also, there is a significant correlation between the pinch strength and activities require precise control of the hand.

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Section: Discussionmentioning

confidence: 99%

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

et al. 2021

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“…Muscle ultrasonography is increasingly used to improve the understanding of musculoskeletal impairments in children with spastic Cerebral Palsy (SCP) (Williams et al ., 2021). During growth, adaptations in skeletal muscles, i.e., an increase in muscle length and anatomical cross-sectional area (aCSA), resulting in increasing muscle volume, occur in both typically developing (TD) children and children with SCP (Benard et al ., 2011; Modlesky and Zhang, 2019; Bell et al ., 2021; Handsfield et al ., 2022). However, these increases are lower in children with SCP compared to TD children (Barber et al ., 2016), while muscle tendons were found to be longer (Barrett and Lichtwark, 2010).…”

Section: Introductionmentioning

confidence: 99%

Muscle morphology and architecture of the medial gastrocnemius between typically developing children with different ancestral backgrounds

Walhain

Declerck

Fat

et al. 2023

Preprint

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Introduction: Muscle ultrasonography is frequently used to improve the understanding of musculoskeletal impairments in children with cerebral palsy. So far, most studies on muscle morphology and architecture have included typically developing children and children with cerebral palsy with similar ancestry, being mainly Caucasian. Less is known about differences in muscle morphology and architecture between children with different ancestral backgrounds. Therefore, the aim of this study was to compare muscle morphology and architecture of the medial gastrocnemius and Achilles tendon of Surinamese typically developing children from African, South Asian and Southeast Asian descent. Method: This explorative cohort study included 100 typically developing children identified as Maroon (Ghana, African descent), Hindustani (India, South Asian) or Javanese (Indonesia, Southeast Asian), aged 5 to 10 years. A conventional B-mode 2D ultrasound was used to define anatomical cross-sectional area (aCSA), fascicle length and pennation angle (architectural parameters). The muscle belly length, volume and physiological cross-sectional area (pCSA), as well as the tendon length (morphological parameters) were defined using 3D freehand ultrasound, which combines B-mode 2D ultrasound with 3D motion tracking. Muscle and tendon lengths were normalized to the total muscle tendon unit (MTU) lengths and fascicle lengths to muscle belly lengths, while volume, aCSA and PCSA were normalized to body mass. One-way Anova with post hoc t-tests were used to investigate differences between the ancestral groups. A two-way repeated measures Anova was used to define whether the extensibility of the muscle tendon, belly and fascicle differed between ancestral groups for the three conditions, i.e. when applying 0Nm, 1Nm and 4Nm ankle dorsiflexion torque. Results: The ancestral subgroups included 34 Hindustani, 34 Javanese and 32 Maroon children. Normalized belly length was 11% shorter in Maroon and 7% shorter in Hindustani children compared to Javanese children (p = <0.001 and p = 0.002, respectively). Normalized fascicle length of Javanese children was 23% longer compared to Maroon and 11% longer compared to Hindustani children (p < 0.001 and p = 0.010, respectively). Normalized muscle volume was significantly higher in Javanese compared to Hindustani children (p = 0.002). The normalized aCSA was higher in Javanese children compared to the Maroon children (p = 0.008), while pCSA was higher for Maroon children compared to the Hindustani children (p = 0.007). The pennation angle of the fascicle with the deeper aponeuroses was larger in Maroon compared to Javanese children (p = 0.015). There were no differences in the extensibility of the muscle belly, tendon and fascicle between ancestral groups. Discussion: Ancestry-specific reference data of the morphology of the medial gastrocnemius and Achilles tendon are needed when investigating altered muscle morphology in children with cerebral palsy. The current study showed differences in morphology (muscle belly-, tendon length and muscle volume, aCSA) and architecture (pCSA, fascicle length and deeper pennation angle) between children with different ancestry. These differences were most pronounced for Javanese compared to Maroon or Hindustani children. Future studies should report the ancestral background when describing muscle morphology and architecture of children and ancestral specifications in normative databases should be included.

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“…Muscle ultrasonography is increasingly used to improve the understanding of musculoskeletal impairments in children with spastic Cerebral Palsy (SCP) (Williams et al, 2021). During growth, adaptations in skeletal muscles, namely an increase in muscle length and anatomical cross‐sectional area (ACSA), resulting in increases muscle volume, occur in both typically developing (TD) children and children with SCP (Bell et al, 2021; Benard et al, 2011; Handsfield et al, 2022; Modlesky & Zhang, 2019). However, these increases are lower in children with SCP compared to TD children (Barber et al, 2016), while tendons are found to be longer (Barrett & Lichtwark, 2010).…”

Section: Introductionmentioning

confidence: 99%

Muscle morphology and architecture of the medial gastrocnemius between typically developing children with different ancestral background

Walhain,

Declerck,

Chin A Fat

et al. 2023

Journal of Anatomy

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Muscle ultrasonography is frequently used to improve the understanding of musculoskeletal impairments in children with spastic cerebral palsy (SCP). So far, most studies on muscle morphology and architecture have included typically developing children and children with SCP with similar ancestry, being mainly Caucasian. Less is known about differences in muscle morphology between children with different ancestral backgrounds. Therefore, the aim of this study was to compare muscle morphology and architecture of the medial gastrocnemius in typically developing children with African, South Asian and Southeast Asian descent from Suriname. This explorative cohort study identified children as Maroon (Ghana, African descent), Hindustani (India, South Asian) or Javanese (Indonesia, Southeast Asian), aged 5–10 years. Using 3D freehand ultrasound with the subject prone, the following medial gastrocnemius parameters were defined: muscle tendon unit (MTU) length, muscle belly length, tendon length, muscle volume, muscle thickness, anatomical cross‐sectional area (ACSA), fascicle length, pennation angle, and physiological cross‐sectional area (PCSA). In addition, differences between ancestral groups were assessed for the length of the MTU, muscle, tendon and fascicles in two passive stretch conditions corresponding to an externally applied joint torque of 1Nm and 4Nm. One‐way ANOVA with post hoc t‐tests were used to investigate differences between the ancestral groups. In total, 100 Hindustani (n = 34), Javanese (n = 34) and Maroon (n = 32) children were included. For statistical analyses, we matched the children by age, which resulted in groups of 25 children per ancestral group (n = 75). There were no differences found in MTU length, muscle belly length, ACSA, PCSA and muscle volume. Tendon length, fascicle length and pennation angle were different between ancestral groups. Compared to Javanese children, tendon length was longer (p = 0.001) and pennation angle (p = 0.001) was larger in Maroon children and fascicle length was shorter in both Maroon and Hindustani children (p < 0.001). While there was a difference found in MTU length at different conditions of passive stretch between ancestries, no differences were found in the muscle, tendon and fascicles. This is the first study that investigated macroscopic morphological and architectural parameters for the medial gastrocnemius in one extended cohort of typically developing children, stratified in three ancestral subgroups. The current results imply that ancestry‐specific reference data for children are needed, especially for tendon length, fascicle length and pennation angle when investigating altered muscle morphology in neurological or neuromuscular pathologies, such as SCP. Future studies should report the ancestral background when describing muscle morphology and architecture of children and ancestral specifications should be included in normative databases.

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Muscle Size, Composition, and Architecture in Cerebral Palsy

Cited by 3 publications

References 86 publications

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

Muscle morphology and architecture of the medial gastrocnemius between typically developing children with different ancestral backgrounds

Muscle morphology and architecture of the medial gastrocnemius between typically developing children with different ancestral background

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