The relationship between lower limb muscle volume and body mass in ambulant individuals with bilateral cerebral palsy

Abstract

BackgroundIndividuals with cerebral palsy have smaller muscle volumes normalised to body mass than their typically developing peers. The aim of this study is to investigate the relationship between lower limb muscle volume and body mass in young people with bilateral cerebral palsy and their typically developing peers.MethodsTwenty-five participants with bilateral cerebral palsy (aged 14.7±3.0 years, GMFCS level I-III) and 25 of their typically developing peers (aged 16.8±3.3 years) took part in this study. None of the participants had undergone orthopaedic surgery, botulinum toxin injections, or serial casting in the previous year. All participants underwent magnetic resonance imaging of both lower limbs. Nine major muscles of each lower limb were individually manually segmented and the muscle volumes calculated.ResultsBody mass and total lower limb muscle volume were significantly linearly related in both the cerebral palsy (R2 = 0.75, p<0.001) and typically developing (R2 = 0.77, p<0.001) groups. The slope of the relationship between muscle volume and body mass was significantly shallower in the cerebral palsy group compared to the typically developing group (p=0.007).ConclusionsThis cross-sectional study suggests that the increase in size of lower limb muscles relative to body mass is reduced in adolescents and young adults with cerebral palsy. Longitudinal studies are required to further investigate altered muscle growth trajectories in this group and their impact on long-term mobility.Electronic supplementary materialThe online version of this article (10.1186/s12883-017-1005-0) contains supplementary material, which is available to authorized users.

Relation of Musculoskeletal Strength and Function to Postural Stability in Ambulatory Adults With Cerebral Palsy

“…21 The reduced bone strength and increased fracture rate in adults with CP could be due to the attenuated structural property of the bone. 20 , 21 , 22 Our data support the importance of skeletal deformities at the proximal femur, which may influence muscular strength and balance in adults with CP. Thus, discovering ways to improve skeletal deformities in the CP population may result in improving functional mobility throughout the lifetime in adults with CP.…”

Measuring skeletal muscle morphology and architecture with imaging modalities in children with cerebral palsy: a scoping review

“…Studies were categorized as observational ( n =45 cross‐sectional, 28–31,33–59,83–90,94,95,97,98,105,106 and n =1 longitudinal), 32 experimental ( n =25), 60–78,91,92,99–101,107 or methodology studies ( n =9) 79–82,93,96,102–104 (Table S2). Of the 25 intervention studies, 60–78,91,92,99–101,107 21 studies used musculoskeletal imaging as an outcome measure after a single intervention: botulinum neurotoxin‐A (BoNT‐A) ( n =6), 76,78,91,99,101,107 strength training ( n =3), 62,71,73 neuromuscular electrical stimulation ( n =3), 63,77,92 surgery ( n =2), 60,72 stretching ( n =2), 45,61 gait training (walk‐run) ( n =1), 65 vibration training ( n =1), 64 an aquatic programme ( n =1), 68 ankle bracing ( n =1), 66 and balance training ( n =1) 100 .…”

The effect of combined functional anaerobic and strength training on treadmill gait kinematics and kinetics in ambulatory young adults with cerebral palsy

“…As individuals with CP develop with age, the plantar flexor muscle growth rate is reduced compared to aged matched TD peers [15], and the muscle size deficit increases relative to total body mass into adulthood [16], which may pose a further challenge for lower limb power generation during gait. The maximum isometric strength of the plantar flexor muscles have been recently shown to explain 61% of the variance in six-minute walk test (6MWT) performance in adults with CP [4].…”