Ann Rehabil Med.  2018 Apr;42(2):286-295. 10.5535/arm.2018.42.2.286.

Relationship Between Functional Level and Muscle Thickness in Young Children With Cerebral Palsy

• Choe YR
• Kim JS
• Kim KH
• Yi TI

• KMID: 2432199
• DOI: http://doi.org/10.5535/arm.2018.42.2.286

Abstract

OBJECTIVE
To investigate the relationship between functional level and muscle thickness (MT) of the rectus femoris (RF) and the gastrocnemius (GCM) in young children with cerebral palsy (CP).
METHODS
The study participants were comprised of 26 children (50 legs) with spastic CP, aged 3-6 years, and 25 age-matched children with typical development (TD, 50 legs). The MT of the RF, medial GCM, and lateral GCM was measured with ultrasound imaging. The functional level was evaluated using the Gross Motor Function Measurement-88 (GMFM-88), Gross Motor Function Classification System (GMFCS), and based on the mobility area of the Korean version of the Modified Barthel Index (K-MBI). The measurement of spasticity was evaluated with the Modified Ashworth Scale (MAS).
RESULTS
We note that the height, weight, body mass index, and MT of the RF, and the medial and lateral GCM were significantly higher in the TD group (p < 0.05). There was a direct relationship between MT of the RF and medial GCM and the GMFM-88, GMFCS, and mobility scores of the K-MBI in individuals with early CP. In addition, we have noted that there was a direct relationship between MT of the lateral GCM and the GMFM-88 and GMFCS. Although there was a tendency toward lower MT with increasing MAS ratings in the knee and ankle, the correlation was not statistically significant.
CONCLUSION
In young children with CP, MT of the RF and GCM was lower than in age-matched children with TD. Furthermore, it is noted with confidence that a significant positive correlation existed between MT and functional level as evaluated using the GMFM-88, GMFCS, and mobility area of K-MBI.

Keyword

Cerebral palsy; Muscle thickness; Gross motor function

MeSH Terms

Ankle
Body Weight
Cerebral Palsy*
Child*
Classification
Humans
Knee
Muscle Spasticity
Quadriceps Muscle
Ultrasonography

Figure

• 

  Fig. 1 Ultrasonographic measurement of muscle thickness: the longest distance between the upper muscular fascia and the lower muscular fascia. These figures show transverse images of (A) RF, (B) medial GCM, and (C) lateral GCM. RF, rectus femoris; GCM, gastrocnemius.

• 

  Fig. 2 Height, weight, and muscle thickness of the RF, medial GCM, and lateral GCM in cerebral palsy (CP) and typical development (TD) groups depending on age. (A) Height, (B) weight, (C) MT of RF, (D) MT of medial GCM, and (E) MT of lateral GCM. RF, rectus femoris; GCM, gastrocnemius; MT, muscle thickness. *p<0.05 by Mann-Whitney U-test independent t-test between CP and TD groups.

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