Article

AIM: To evaluate spasticity under controlled velocities and torques in children
with cerebral palsy (CP) using a manual spasticity evaluator. METHOD: The study
involved 10 children with spastic CP (six males, four females; mean age 10 y 1
mo, SD 2 y 9 mo, range 7-16 y; one with quadriplegia, six with right hemiplegia,
three with left hemiplegia; Gross Motor Function Classification System levels I
[n=2], II [n=3], III [n=2], IV [n=2], and V [n=1]; Manual Ability Classification
System levels II [n=5], III [n=4], and V [n=1]) and 10 typically developing
participants (four males, six females; mean age 10 y 3 mo, SD 2 y 7 mo, range
7-15 y). Spasticity and catch angle were evaluated using joint position,
resistance torque, and torque rate at velocities of 90 degrees, 180 degrees, and
270 degrees per second, controlled using real-time audio-visual feedback.
Biomechanically, elbow range of motion (ROM), stiffness, and energy loss were
determined during slow movement (30 degrees/s) and under controlled terminal
torque. RESULTS: Compared with typically developing children, children with CP
showed higher reflex-mediated torque (p<0.001) and the torque increased more
rapidly with increasing velocity (p<0.001). Catch angle was dependent on velocity
and occurred later with increasing velocity (p=0.005). Children with CP showed
smaller ROM (p<0.05), greater stiffness (p<0.001), and more energy loss
(p=0.003). INTERPRETATION: Spasticity with velocity dependence may also be
position-dependent. The delayed catch angle at higher velocities indicates that
the greater resistance felt by the examiner at higher velocities was also due to
position change, because the joint was moved further to a stiffer position at
higher velocities.

Langue : ANGLAIS