Pathophysiology of Muscle Contractures in Cerebral Palsy

Mathewson, Margie A.; Lieber, Richard L.

doi:10.1016/j.pmr.2014.09.005

Cited by 154 publications

(140 citation statements)

References 54 publications

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“…The decrease in lean mass reflects nutritional factors and primary cerebral palsy alterations, such as neuromotor dysfunction that induces sarcomere reduction, fiber size, lipid content, collagen and muscle capillary density, thus altering the final muscle composition [16]. Neuroendocrine changes and immobility also interfere in the stimulation of muscle trophism [17].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

et al. 2017

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A B S T R A C T ObjectiveTo evaluate the frequency of malnutrition and food consumption of children with cerebral palsy according to the age at the beginning of speech and hearing rehabilitation treatment. MethodsTwo to eleven-year-old children diagnosed with cerebral palsy who had up to three months of speech-language and nutritional rehabilitation were included in two reference centers in Recife, Pernambuco, Brazil. measurement of the children were taken: weight, knee height, arm circumference and triceps skinfold. Weight, estimated height and body mass index were classified into Z-scores according to the World Health Organization curves. Brachial circumference, triceps skinfold and arm circumference were classified according to Frisancho. The 24-hour recall was used to calculate intake of calories, proteins, calcium, iron, vitamin A, and zinc using the NutriWin software. ResultsA total of 68 patients were evaluated. Children older than five had a higher frequency of malnutrition when weight (p=0.02) and arm circumference (p<0.001) were considered, although there was less triceps malnutrition (p=0.002). These also had lower calorie consumption per kg/day, protein/kg/day and calcium than the younger children. ConclusionThe greatest nutritional impairment after the age of five suggests that nutritional and speech therapy interventions could have a greater effect if they were performed before that age.Keywords: Cerebral palsy. Child. Eating behavior. Food consumption. Malnutrition. R E S U M O Objetivo Avaliar frequência da desnutrição e consumo alimentar de crianças com paralisia cerebral de acordo com a idade do início do tratamento de reabilitação fonoaudiológica e nutricional. Métodos Foram incluídas crianças de 2 a 11 anos com diagnóstico de paralisia cerebral e que tinham até três meses de reabilitação fonoaudiológica e nutricional em dois centros de referência em I N T R O D U C T I O NCerebral palsy, the most common cause of physical disability in children, is characterized by permanent disorders of posture and movement [1] and it affects between 2-2.5 per thousand live births worldwide [2]. Cerebral palsy is not progressive, however, due to its motor sequelae and eating difficulties, these children can develop nutritional impairments that prevent early brain development and plasticity [3], leading to impaired health conditions, quality of life and cognitive performance [4].Malnutrition in cerebral palsy is multifactorial. In addition to the nutritional status, other factors such as primary neurological damage, which interferes with muscle constitution, endocrinological factors, immobility and caregiving demands, and overall health conditions may interfere in

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Section: Discussionmentioning

confidence: 99%

Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

et al. 2017

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“…Changes within the soft tissues lead to shortening of structures surrounding the joint and are responsible for nonneural elements of contractures (Mathewson and Lieber, 2015).…”

Section: Table One Herementioning

confidence: 99%

How effective is stretching in maintaining range of movement for children with cerebral palsy? A critical review

Eldridge

Lavin²

2016

International Journal of Therapy and Rehabilitation

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“…Because weakness in children with CP is usually treated at the muscle level, treatment goals and effects should as well be addressed at the muscle [7]. Evaluation of muscle structure gives us a better understanding of how muscles contribute to force generation [8][9][10] in children with CP, and in turn, to gait ability [4,5] and should therefore be assessed in detail [3,7,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, muscle structure has shown to be significantly correlated to muscle strength in TD children [13] and in children with CP [8][9][10]. Thus, there is a relationship between how the muscle is structured and the capacity to generate muscle force such as maximal isometric strength [8][9][10], velocity of isometric strength generation [9], and isokinetic strength [10].…”

Section: Introductionmentioning

confidence: 99%

“…Muscle structure parameters affecting number of sarcomeres in parallel such as muscle thickness have been significantly correlated to strength development in both children with CP and TD [8][9][10]. However, the scientific literature has shown conflicting results regarding muscle structure parameters reflecting number of sarcomeres in series such as fascicle length which determine muscle excursion and velocity [11].…”

Section: Introductionmentioning

confidence: 99%

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Relative fascicle excursion effects on dynamic strength generation during gait in children with cerebral palsy

et al. 2015

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Evaluation of muscle structure gives us a better understanding of how muscles contribute to force generation which is significantly altered in children with cerebral palsy (CP). While most muscle structure parameters have shown to be significantly correlated to different expressions of strength development in children with CP and typically developing (TD) children, conflicting results are found for muscle fascicle length. Muscle fascicle length determines muscle excursion and velocity, and contrary to what might be expected, correlations of fascicle length to rate of force development have not been found for children with CP. The lack of correlation between muscle fascicle length and rate of force development in children with CP could be due, on the one hand, to the non-optimal joint position adopted for force generation on the isometric strength tests as compared to the position of TD children. On the other hand, the lack of correlation could be due to the erroneous assumption that muscle fascicle length is representative of sarcomere length. Thus, the relationship between muscle architecture parameters reflecting sarcomere length, such as relative fascicle excursions and dynamic power generation, should be assessed. Understanding of the underlying mechanisms of weakness in children with CP is key for individualized prescription and assessment of muscle-targeted interventions. Findings could imply the detection of children operating on the descending limb of the sarcomere length-tension curve, which in turn might be at greater risk of developing crouch gait. Furthermore, relative muscle fascicle excursions could be used as a predictive variable of outcomes related to crouch gait prevention treatments such as strength training.

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Pathophysiology of Muscle Contractures in Cerebral Palsy

Cited by 154 publications

References 54 publications

Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

How effective is stretching in maintaining range of movement for children with cerebral palsy? A critical review

Relative fascicle excursion effects on dynamic strength generation during gait in children with cerebral palsy

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