Hyperactive stretch reflexes, co‐contraction, and muscle weakness in children with cerebral palsy
The aim of this study was to examine the repeatability of and relationships among spasticity, co‐contraction of agonist–antagonist, and muscle strength in children with cerebral palsy (CP). Eight children with spastic diplegic CP (five males, three females; Gross Motor Function Classification System...
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| Veröffentlicht in: | Developmental medicine and child neurology 2009-02, Vol.51 (2), p.128-135 |
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| description | The aim of this study was to examine the repeatability of and relationships among spasticity, co‐contraction of agonist–antagonist, and muscle strength in children with cerebral palsy (CP). Eight children with spastic diplegic CP (five males, three females; Gross Motor Function Classification System [GMFCS] Levels I–III; mean age 10y 2mo [SD 2y 9mo], range 6–13y) and nine children in a comparison group (six males, three females; mean age 8y 10mo [SD 2y 4mo], range 6y to 12y 6mo) were assessed twice to examine repeatability of Composite Spasticity Scale, soleus stretch reflexes, electromyography (EMG) co‐contraction ratio, and torque recorded during maximal isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Sixty‐one children with spastic CP, (54 diplegic, seven hemiplegic; 32 males, 29 females; GMFCS levels I–III; mean age 10y 8mo [SD 2y 9mo], range 6–15y) were then assessed to delineate possible correlations among these measures. Intraclass correlation coefficients (0.78–0.97) showed high data repeatability in both groups. Children with spastic CP demonstrated significantly larger soleus stretch reflex/M‐response areas smaller torques, but larger EMG co‐contraction ratios during both voluntary dorsiflexion and plantarflexion (all p |
| doi_str_mv | 10.1111/j.1469-8749.2008.03122.x |
| format | Article |
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Eight children with spastic diplegic CP (five males, three females; Gross Motor Function Classification System [GMFCS] Levels I–III; mean age 10y 2mo [SD 2y 9mo], range 6–13y) and nine children in a comparison group (six males, three females; mean age 8y 10mo [SD 2y 4mo], range 6y to 12y 6mo) were assessed twice to examine repeatability of Composite Spasticity Scale, soleus stretch reflexes, electromyography (EMG) co‐contraction ratio, and torque recorded during maximal isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Sixty‐one children with spastic CP, (54 diplegic, seven hemiplegic; 32 males, 29 females; GMFCS levels I–III; mean age 10y 8mo [SD 2y 9mo], range 6–15y) were then assessed to delineate possible correlations among these measures. Intraclass correlation coefficients (0.78–0.97) showed high data repeatability in both groups. Children with spastic CP demonstrated significantly larger soleus stretch reflex/M‐response areas smaller torques, but larger EMG co‐contraction ratios during both voluntary dorsiflexion and plantarflexion (all p<0.05). Children with spastic CP who had larger soleus stretch reflex/M‐response areas demonstrated larger plantarflexion co‐contraction ratio (r = 0.28), and produced smaller plantarflexion and dorsiflexion torques (r = –0.48 and –0.27 respectively). However, no correlation was noted between soleus stretch reflex and clinical spasticity. Our findings demonstrated that hyperactive soleus stretch reflex affected torque production of ankle muscles. Moreover, the severity of spasticity may not be fully described by either stretch reflex or tone measure alone.</description><identifier>ISSN: 0012-1622</identifier><identifier>EISSN: 1469-8749</identifier><identifier>DOI: 10.1111/j.1469-8749.2008.03122.x</identifier><identifier>PMID: 19018843</identifier><identifier>CODEN: DMCNAW</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Cerebral Palsy ; Cerebral Palsy - complications ; Child ; Correlation ; Electromyography ; Female ; Females ; Humans ; Male ; Males ; Muscle Contraction - physiology ; Muscle Spasticity ; Muscle Weakness - etiology ; Muscle, Skeletal - physiopathology ; Muscular Strength ; Physical Fitness ; Reflex, Stretch - physiology ; Reproducibility of Results ; Special Schools ; Statistics as Topic ; Torque</subject><ispartof>Developmental medicine and child neurology, 2009-02, Vol.51 (2), p.128-135</ispartof><rights>The Authors. Journal compilation © Mac Keith Press 2008</rights><rights>Copyright Mac Keith Press Feb 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4452-e2fb3122372dcc4ee23d97ced35b6798fa93912a922c55749afbae26f957c9973</citedby><cites>FETCH-LOGICAL-c4452-e2fb3122372dcc4ee23d97ced35b6798fa93912a922c55749afbae26f957c9973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1469-8749.2008.03122.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1469-8749.2008.03122.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19018843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>POON, DORA M Y</creatorcontrib><creatorcontrib>HUI‐CHAN, CHRISTINA W Y</creatorcontrib><title>Hyperactive stretch reflexes, co‐contraction, and muscle weakness in children with cerebral palsy</title><title>Developmental medicine and child neurology</title><addtitle>Dev Med Child Neurol</addtitle><description>The aim of this study was to examine the repeatability of and relationships among spasticity, co‐contraction of agonist–antagonist, and muscle strength in children with cerebral palsy (CP). Eight children with spastic diplegic CP (five males, three females; Gross Motor Function Classification System [GMFCS] Levels I–III; mean age 10y 2mo [SD 2y 9mo], range 6–13y) and nine children in a comparison group (six males, three females; mean age 8y 10mo [SD 2y 4mo], range 6y to 12y 6mo) were assessed twice to examine repeatability of Composite Spasticity Scale, soleus stretch reflexes, electromyography (EMG) co‐contraction ratio, and torque recorded during maximal isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Sixty‐one children with spastic CP, (54 diplegic, seven hemiplegic; 32 males, 29 females; GMFCS levels I–III; mean age 10y 8mo [SD 2y 9mo], range 6–15y) were then assessed to delineate possible correlations among these measures. Intraclass correlation coefficients (0.78–0.97) showed high data repeatability in both groups. Children with spastic CP demonstrated significantly larger soleus stretch reflex/M‐response areas smaller torques, but larger EMG co‐contraction ratios during both voluntary dorsiflexion and plantarflexion (all p<0.05). Children with spastic CP who had larger soleus stretch reflex/M‐response areas demonstrated larger plantarflexion co‐contraction ratio (r = 0.28), and produced smaller plantarflexion and dorsiflexion torques (r = –0.48 and –0.27 respectively). However, no correlation was noted between soleus stretch reflex and clinical spasticity. Our findings demonstrated that hyperactive soleus stretch reflex affected torque production of ankle muscles. Moreover, the severity of spasticity may not be fully described by either stretch reflex or tone measure alone.</description><subject>Adolescent</subject><subject>Cerebral Palsy</subject><subject>Cerebral Palsy - complications</subject><subject>Child</subject><subject>Correlation</subject><subject>Electromyography</subject><subject>Female</subject><subject>Females</subject><subject>Humans</subject><subject>Male</subject><subject>Males</subject><subject>Muscle Contraction - physiology</subject><subject>Muscle Spasticity</subject><subject>Muscle Weakness - etiology</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Muscular Strength</subject><subject>Physical Fitness</subject><subject>Reflex, Stretch - physiology</subject><subject>Reproducibility of Results</subject><subject>Special Schools</subject><subject>Statistics as Topic</subject><subject>Torque</subject><issn>0012-1622</issn><issn>1469-8749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkclOwzAQhi0EgrK8ArI4cGqClyz2BQmVVWK5wNlynImakibFTmh74xF4Rp4Ep61A4sRc5jDf_Jr5f4QwJSH1dTYJaZTIQKSRDBkhIiScMhYuttDgZ7CNBoRQFtCEsT2079yEEMKTONpFe1QSKkTEB8jcLmdgtWnLd8CutdCaMbZQVLAAN8Sm-fr4NE3drpCmHmJd53jaOVMBnoN-rcE5XNbYjMsqt1DjedmOsQELmdUVnunKLQ_RTuE7HG36AXq5vnoe3Qb3Tzd3o4v7wERRzAJgRda_wVOWGxMBMJ7L1EDO4yxJpSi05JIyLRkzcew_1EWmgSWFjFMjZcoP0Olad2abtw5cq6alM1BVuoamcypJhEgF4R48-QNOms7W_jZFZRxLGfHEQ2INGds45y1RM1tOtV0qSlSfgpqo3mzVm636FNQqBbXwq8cb_S6bQv67uLHdA-drYF5WsPy3sLp8GD2uLPoGy7eXuQ</recordid><startdate>200902</startdate><enddate>200902</enddate><creator>POON, DORA M Y</creator><creator>HUI‐CHAN, CHRISTINA W Y</creator><general>Blackwell Publishing Ltd</general><general>Mac Keith Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>200902</creationdate><title>Hyperactive stretch reflexes, co‐contraction, and muscle weakness in children with cerebral palsy</title><author>POON, DORA M Y ; HUI‐CHAN, CHRISTINA W Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4452-e2fb3122372dcc4ee23d97ced35b6798fa93912a922c55749afbae26f957c9973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Cerebral Palsy</topic><topic>Cerebral Palsy - complications</topic><topic>Child</topic><topic>Correlation</topic><topic>Electromyography</topic><topic>Female</topic><topic>Females</topic><topic>Humans</topic><topic>Male</topic><topic>Males</topic><topic>Muscle Contraction - physiology</topic><topic>Muscle Spasticity</topic><topic>Muscle Weakness - etiology</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Muscular Strength</topic><topic>Physical Fitness</topic><topic>Reflex, Stretch - physiology</topic><topic>Reproducibility of Results</topic><topic>Special Schools</topic><topic>Statistics as Topic</topic><topic>Torque</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>POON, DORA M Y</creatorcontrib><creatorcontrib>HUI‐CHAN, CHRISTINA W Y</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Developmental medicine and child neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>POON, DORA M Y</au><au>HUI‐CHAN, CHRISTINA W Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperactive stretch reflexes, co‐contraction, and muscle weakness in children with cerebral palsy</atitle><jtitle>Developmental medicine and child neurology</jtitle><addtitle>Dev Med Child Neurol</addtitle><date>2009-02</date><risdate>2009</risdate><volume>51</volume><issue>2</issue><spage>128</spage><epage>135</epage><pages>128-135</pages><issn>0012-1622</issn><eissn>1469-8749</eissn><coden>DMCNAW</coden><abstract>The aim of this study was to examine the repeatability of and relationships among spasticity, co‐contraction of agonist–antagonist, and muscle strength in children with cerebral palsy (CP). Eight children with spastic diplegic CP (five males, three females; Gross Motor Function Classification System [GMFCS] Levels I–III; mean age 10y 2mo [SD 2y 9mo], range 6–13y) and nine children in a comparison group (six males, three females; mean age 8y 10mo [SD 2y 4mo], range 6y to 12y 6mo) were assessed twice to examine repeatability of Composite Spasticity Scale, soleus stretch reflexes, electromyography (EMG) co‐contraction ratio, and torque recorded during maximal isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Sixty‐one children with spastic CP, (54 diplegic, seven hemiplegic; 32 males, 29 females; GMFCS levels I–III; mean age 10y 8mo [SD 2y 9mo], range 6–15y) were then assessed to delineate possible correlations among these measures. Intraclass correlation coefficients (0.78–0.97) showed high data repeatability in both groups. Children with spastic CP demonstrated significantly larger soleus stretch reflex/M‐response areas smaller torques, but larger EMG co‐contraction ratios during both voluntary dorsiflexion and plantarflexion (all p<0.05). Children with spastic CP who had larger soleus stretch reflex/M‐response areas demonstrated larger plantarflexion co‐contraction ratio (r = 0.28), and produced smaller plantarflexion and dorsiflexion torques (r = –0.48 and –0.27 respectively). However, no correlation was noted between soleus stretch reflex and clinical spasticity. Our findings demonstrated that hyperactive soleus stretch reflex affected torque production of ankle muscles. Moreover, the severity of spasticity may not be fully described by either stretch reflex or tone measure alone.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19018843</pmid><doi>10.1111/j.1469-8749.2008.03122.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Developmental medicine and child neurology, 2009-02, Vol.51 (2), p.128-135 |
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| source | MEDLINE; Wiley Free Content; Wiley Online Library All Journals |
| subjects | Adolescent Cerebral Palsy Cerebral Palsy - complications Child Correlation Electromyography Female Females Humans Male Males Muscle Contraction - physiology Muscle Spasticity Muscle Weakness - etiology Muscle, Skeletal - physiopathology Muscular Strength Physical Fitness Reflex, Stretch - physiology Reproducibility of Results Special Schools Statistics as Topic Torque |
| title | Hyperactive stretch reflexes, co‐contraction, and muscle weakness in children with cerebral palsy |
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