Article

This study examined the sensitivity of an instrumented spasticity assessment of
the medial hamstrings (MEH) in children with cerebral palsy (CP). Nineteen
children received Botulinum Toxin type A (BTX-A) injections in the MEH.
Biomechanical (position and torque) and electrophysiological (surface
electromyography, EMG) signals were integrated during manually-performed passive
stretches of the MEH at low, medium and high velocity. Signals were examined at
each velocity and between stretch velocities, and compared pre and post BTX-A (43
+/- 16 days). Average change between pre and post BTX-A was interpreted in view
of the minimal detectable change (MDC) calculated from previously published
reliability results. Improvements greater than the MDC were found for nearly all
EMG-parameters and for torque parameters at high velocity and at high versus low
velocity (p<0.03), however large inter-subject variability was noted. Moderate
correlations were found between the improvement in EMG and in torque (r=0.52,
p<0.05). Biomechanical and electrophysiological parameters proved to be
adequately sensitive to assess the response to treatment with BTX-A. Furthermore,
studying both parameters at different velocities improves our understanding of
spasticity and of the physiological effect of selective tone-reduction. This not
only provides a clinical validation of the instrumented assessment, but also
opens new avenues for further spasticity research.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS