Article

Muscle weakness is a recognised problem in children with Cerebral Palsy (CP).
Changes in the understanding of motor control, and progress in the treatment of
spasticity, have led to a greater appreciation that spastic muscles are also
weak. In recent years weakness has been identified in isolated muscle groups, but
studies quantifying the degree and distribution of weakness in multiple muscles
remain limited. This study evaluated isometric lower limb muscle strength in 50
ambulant children with CP/Spastic Diplegia (mean age 11 years 7 months) at GMFCS
levels I (n=14), II (n=26) and III (n=10). Muscle strength was compared with 15
control children (mean age 11 years 1 month) using the same protocol. Six muscle
groups in both lower limbs were measured using a digital dynamometer. All lower
limb muscles were significantly weaker in the CP children than in healthy
children (p<0.05) except for the hip extensors. Muscle strength ranged from 43%
to 90% of control values depending on the muscle group, with the knee extensors
measured at 30 degrees being the relatively weakest group. There was a
significant difference in strength between GMFCS levels in 4/6 muscle groups with
a progressive reduction in strength in all muscle groups with increasing walking
difficulty from GMFCS levels I to III. The greatest difference in strength
between independent walkers and those dependent on walking aids was in the hip
abductors and knee extensors at 30 degrees , which are key muscle groups in
sagittal and coronal plane walking stability. This has implications in targetting
strength training to maximise functional outcomes.
CI - Copyright (c) 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS