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Comparative Study
, 13 (1), e0190642
eCollection

Comparison of Calf Muscle Architecture Between Asian Children With Spastic Cerebral Palsy and Typically Developing Peers

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Comparative Study

Comparison of Calf Muscle Architecture Between Asian Children With Spastic Cerebral Palsy and Typically Developing Peers

Ying Chen et al. PLoS One.

Abstract

Objective: To compare the muscle thickness, fascicle length, and pennation angle of the gastrocnemius, soleus, and tibialis anterior between Asian children with spastic cerebral palsy (CP) and typically developing (TD) peers.

Methods: This cross-sectional study involved a total of 72 children with hemiplegic CP (n = 24), and diplegic CP (n = 24) and their TD peers (n = 24). Muscle architecture was measured at rest using ultrasound. Clinical measures included gross motor function and a modified Ashworth scale.

Results: The thicknesses of the tibialis anterior and medial gastrocnemius muscles were smaller in the affected calf of children with CP (p<0.05) than in those of their TD peers. Additionally, the lengths of the lateral gastrocnemius and soleus fascicle were shorter (p<0.05) in children with diplegic CP than in their TD peers. The fascicle length was shorter in the affected calf of children with CP (p<0.05) than in the calves of their TD peers or the unaffected calf of children with hemiplegic CP. However, the length of the lateral gastrocnemius fascicle was similar between the two legs of children with hemiplegic CP. The pennation angles of the medial gastrocnemius and soleus muscles were larger (p<0.05) in the affected calf in children with hemiplegic CP than in the calves of their TD peers. The fascicle length of the lateral gastrocnemius and the thickness of the soleus muscle were positively correlated with gross motor function scores in children with CP (p<0.05).

Conclusions: Muscle thickness and fascicle length were lower in the affected tibialis anterior, gastrocnemius, and soleus in children with spastic CP. These changes may limit the ability to stand and walk, and indicate a need to strengthen the affected muscle.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of case screening and measurement protocols.
Fig 2
Fig 2
Ultrasonic images of calf muscles measured at rest: (a) tibialis anterior (TA), (b) medial gastrocnemius (MG), (c) lateral gastrocnemius (LG), and (d) soleus (SOL). θ indicates the pennation angle; APO, Aponeurosis; MT1 indicates the distance from the fiber distal end point to the superficial aponeurosis; MT2 indicates the distance from the fiber proximal end to the deep aponeurosis; Lm, Longest fiber length in the visible section by ultrasound.
Fig 3
Fig 3
Comparison of at-rest muscle thickness (a), fascicle length (b), and pennation angle (c) in calf muscles among the groups with hemiplegic cerebral palsy (HCP), diplegic cerebral palsy (DCP), and typically developing (TD) (mean ± SD). TA, tibialis anterior; MG, medial gastrocnemius; LG, lateral gastrocnemius; SOL, soleus. *Significant group difference (p<0.05).

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Publication types

Grant support

This work was supported by the National Natural Science Foundation of China (HD 81672253) to KSX, the Guangdong Provincial Department of Science and Technology (HD 2014A020212469 and 2015A030401006) to KSX, the Guangzhou Science Technology and Innovation Commission (HD 2014J4100136 and 201508020003) to KSX, and a fund from the Guangzhou Women and Children’s Medical Center/Guangzhou Institute of Pediatrics (YIP-2016-015 to LH and YIP-2016-007 to KSX), Guangzhou, China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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