Muscle and tendon morphology alterations in children and adolescents with mild forms of spastic cerebral palsy

Early detection of changes at the muscular level before a contracture develops is important to gain knowledge about the development of deformities in individuals with spasticity. However, little information is available about muscle morphology in children with spastic diplegic cerebral palsy (CP) without contracture or equinus gait. Therefore, the aim of this study was to compare the gastrocnemius medialis (GM) and Achilles tendon architecture of children and adolescents with spastic CP without contracture or equinus gait to that of typically developing (TD) children. Two-dimensional ultrasonography was used to assess the morphological properties of the GM muscle and Achilles tendon in 10 children with spastic diplegic CP (Gross Motor Function Classification System level I-II) and 12 TD children (mean age 12.0 (2.8) and 11.3 (2.5) years, respectively). The children with CP were not restricted in the performance of daily tasks, and therefore had a high functional capacity. Mean muscle and tendon parameters were statistically compared (independent t-tests or Mann-Whitney U-tests). When normalized to lower leg length, muscle-tendon unit length and GM muscle belly length were found to be significantly shorter (p