Article

Spasticity is a velocity dependent feature present in most
patients with cerebral palsy (CP). It is commonly measured in a passive
condition. The aim of this study was to highlight markers of spasticity of
gastrocnemius and hamstring muscles during gait by comparing the effect of
increased walking velocity of CP and typical developing (TD) children. METHODS:
53 children with spastic CP and 17 TD children were instructed to walk at
self-selected speed, faster and as fast as possible without running. Kinematics,
kinetics and electromyography (EMG) were collected and muscle length and muscle
lengthening velocity (MLV) were calculated. To compare the data of both groups, a
linear regression model was created which resulted in two non-dimensional gait
velocities. A difference score (DS) was calculated between the high and low
velocity values for both groups. RESULTS: 103 gait parameters were analyzed of
which 16 had a statistically significant DS between TD and CP groups. The spastic
gastrocnemius muscle presented at high velocity with a higher ankle angular
velocity, plantar flexion moment, power absorption and increased EMG signal
during loading response. The spastic hamstrings demonstrated at high velocity a
delayed maximum knee extension moment at mid-stance and increasing hip extension
moment and hip power generation. The hamstrings also presented with a lower MLV
during swing phase. CONCLUSIONS: A limited number of gait parameters differ
between CP and TD children when increasing walking velocity, giving indirect
insight on the effect of spasticity on gait.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS