Relationship Between Age and Spasticity in Children With Diplegic Cerebral Palsy

• Published in: Archives of physical medicine and rehabilitation Vol. 91; no. 3; pp. 448 - 451
• Main Authors: Pierce, Samuel R., PT, PhD, NCS, Prosser, Laura A., PT, PhD, Lauer, Richard T., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2010; Elsevier
• Subjects: Adolescent; Age Factors; Aging; Biological and medical sciences; Cerebral palsy; Cerebral Palsy - complications; Cerebral Palsy - rehabilitation; Child; Diseases of the osteoarticular system; Elasticity; Electromyography; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Knee - physiopathology; Male; Medical sciences; Movement; Muscle spasticity; Muscle Spasticity - etiology; Muscle Spasticity - physiopathology; Muscle Spasticity - rehabilitation; Muscle Strength Dynamometer; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Physical Medicine and Rehabilitation; Range of Motion, Articular; Rehabiliation; Retrospective Studies; Cerebral palsy; Gross Motor Function Classification System; vastus lateralis; CP; medial hamstrings; Rehabiliation; electromyography; VL; Aging; MH; GMFCS; Muscle spasticity; EMG; Human; Nervous system diseases; Spasticity; Muscle tonus alteration; Cerebral disorder; Striated muscle disease; Orthopedics; Central nervous system disease; Neurological disorder; Child; Age
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2009.11.016

Abstract Pierce SR, Prosser LA, Lauer RT. Relationship between age and spasticity in children with diplegic cerebral palsy. Objective To examine the relationship between passive torque, reflex activity, co-contraction, and age during the assessment of spasticity of knee flexors and extensors in children with spastic diplegic cerebral palsy (CP). Design Retrospective. Setting Pediatric orthopedic hospital. Participants Children (N=36) with spastic diplegic CP. Interventions Not applicable. Main Outcome Measures Spasticity of the knee flexors and knee extensors (as measured by peak passive torque, mean passive torque, reflex activity of the medial hamstrings, reflex activity of vastus lateralis, and co-contraction) was assessed during passive movements completed using an isokinetic dynamometer with concurrent electromyography. Results A significant positive relationship was found between age and mean knee flexor passive torque ( P <.05), while a significant negative relationship was found between age and mean percentage of the range of motion with co-contraction ( P <.05). Conclusions Our results suggest that passive stiffness may play a larger role in spasticity than reflex activity as children with spastic diplegic CP age. Additional research is needed to determine whether subject age could influence the effectiveness of interventions, such as serial casting or botulinum toxin, for spasticity in children with spastic diplegic CP.