Givon Uri
Pediatric Orthopedic Unit, Safra Hospital for Children, Tel Hashomer, 52621, Israel.
Acta Orthop Traumatol Turc. 2009 Mar-Apr;43(2):87-93. doi: 10.3944/AOTT.2009.087.
Over the last two decades, muscle weakness has been shown to be a major component of cerebral palsy (CP) pathology. Caused by multiple etiologies including variations in the muscle fiber type, pathologic motor unit function, co-contraction of agonists and antagonists, and muscle size and rigidity, weakness interferes with function and leads to limited function and participation. Muscle strength was found to be associated with walking ability and with functional scales. Children with CP were found to be weaker than typically developing children, and differences were found with respect to muscle groups in children with CP. Muscle weakness should be evaluated as objectively as possible to improve the quality of diagnosis and treatment. Manual muscle testing is not sufficient for evaluation, and instrumented muscle testing is validated in CP. Muscle strengthening is an important part of treatment of CP. Several methods of strengthening have been described. Muscle lengthening and other spasticity-modifying therapies have been shown to have a positive effect on muscle strength. Children who participated in muscle strengthening programs had a better quality of life and improved function.
在过去二十年中，肌肉无力已被证明是脑性瘫痪（CP）病理的主要组成部分。它由多种病因引起，包括肌纤维类型的变化、病理性运动单位功能、主动肌和拮抗肌的共同收缩以及肌肉大小和僵硬程度，肌肉无力会干扰功能并导致功能受限和参与受限。研究发现肌肉力量与行走能力和功能量表相关。患有CP的儿童比正常发育的儿童更虚弱，并且在患有CP的儿童中不同肌肉群存在差异。应尽可能客观地评估肌肉无力，以提高诊断和治疗质量。徒手肌力测试不足以进行评估，而仪器化肌肉测试在CP中已得到验证。肌肉强化是CP治疗的重要组成部分。已经描述了几种强化方法。肌肉延长和其他缓解痉挛的疗法已被证明对肌肉力量有积极影响。参加肌肉强化计划的儿童生活质量更好，功能也有所改善。
