Contributing factors to muscle weakness in children with cerebral palsy
Contributing factors to muscle weakness in children with cerebral palsy
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DOI：
10.1111/j.1469-8749.2003.tb00954.x
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发表时间：
2003-08-01
影响因子：
3.8
通讯作者：
Leahey, L
中科院分区：
文献类型：
--
作者：
Elder, GCB;Kirk, J;Leahey, L
本研究的目的是确定脑性瘫痪(CP)儿童踝部肌肉无力的程度，并找出潜在的原因。测定14例(男7例，女7例)和14例(男8例，女6例)偏瘫患儿双腿屈伸膝关节最佳角度的足底(PF)和背屈(DF)的最大自主收缩。他们的结果与14名年龄和体重匹配的对照组参与者(5名男性，9名女性)进行了比较。对14例脑性瘫痪儿童(双瘫8例，偏瘫6例)和18例正常儿童的比目鱼肌、后室肌和前室肌的横截面积进行了MRI测量。根据扭矩和横截面积结果确定PF和DF的比张力(扭矩/单位面积)。还测定了5名正常儿童和5名偏瘫儿童双腿的PF和DF的肌肉体积。在每次最大自主收缩时，记录比目鱼肌、腓肠肌内侧和胫骨前肌的肌电。两个CP组的PF和DF的平均波幅显著降低，拮抗剂的共激活水平显著高于对照组。两个CP组的PF和DF的强度都显著降低，但更重要的是，由于比张力显著降低，肌肉被发现较弱。PF受影响最大，尤其是偏瘫患者。据信，无法最大限度地激活他们的肌肉是造成这种虚弱的原因之一。不完全激活和高水平的PF共激活被认为是导致DF虚弱的原因。
The aim of this study was to determine the extent of ankle muscle weakness in children with cerebral palsy (CP) and to identify potential causes. Maximal voluntary contractions of plantar (PF) and dorsiflexors (DF) were determined at optimal angles in knee flexion and extension in both legs of 14 children with hemiplegia (7 males, 7 females) and 14 with diplegia (8 males, 6 females). Their results were compared to 14 age- and weight-matched control participants (5 males, 9 females). Muscle cross-sectional areas of soleus, posterior, and anterior compartment muscles were determined from MRIs in 14 children with CP (eight diplegia, six hemiplegia) and 18 control children. Specific tension (torque/unit area) of PF and DF was determined from torque and cross-sectional area results. Muscle volumes of PF and DF were also determined in both legs of five control children and five with hemiplegia. Muscle EMG was recorded from soleus, medial gastrocnemius, and tibialis anterior during each maximal voluntary contraction. Mean amplitude was significantly reduced in PF and DF in both CP groups and significantly higher levels of coactivation of antagonists were found compared to control participants.Strength of PF and DF was significantly reduced in both CP groups, but more importantly the muscles were found to be weak based on significantly reduced specific tensions. The PF were most affected, particularly in the group with hemiplegia. It is believed that an inability to maximally activate their muscles contributed to this weakness. A combination of incomplete activation and high levels of PF coactivation are thought to have contributed to DF weakness.