Article

OBJECTIVE: To examine the relationship between passive torque, reflex activity,
co-contraction, and age during the assessment of spasticity of knee flexors and
extensors in children with spastic diplegic cerebral palsy (CP). DESIGN:
Retrospective. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Children
(N=36) with spastic diplegic CP. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Spasticity of the knee flexors and knee extensors (as measured by peak
passive torque, mean passive torque, reflex activity of the medial hamstrings,
reflex activity of vastus lateralis, and co-contraction) was assessed during
passive movements completed using an isokinetic dynamometer with concurrent
electromyography. RESULTS: A significant positive relationship was found between
age and mean knee flexor passive torque (P<.05), while a significant negative
relationship was found between age and mean percentage of the range of motion
with co-contraction (P<.05). CONCLUSIONS: Our results suggest that passive
stiffness may play a larger role in spasticity than reflex activity as children
with spastic diplegic CP age. Additional research is needed to determine whether
subject age could influence the effectiveness of interventions, such as serial
casting or botulinum toxin, for spasticity in children with spastic diplegic CP.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS