Lee Dae-Yeon
Faculty of Liberal Arts, Kangnam University, Yongin, Korea.
J Exerc Rehabil. 2019 Jun 30;15(3):445-448. doi: 10.12965/jer.1938216.108. eCollection 2019 Jun.
The purpose of this study is to analyze the lengths of the medial and lateral gastrocnemius and soleus muscles in children with spastic hemiplegic cerebral palsy to quantitatively assess the structural differences in skeletal muscles. This study included 10 children with spastic cerebral palsy and 10 children with typically development. To assess the changes in the length of the ankle plantar flexor due to cerebral palsy, we utilized both gait analysis and software for interactive musculoskeletal modeling to model skeletal muscle length. With this model, the differences in the lengths of the medial and lateral gastrocnemius and soleus muscles were assessed at different knee (0°, 45°, and 90°) and ankle (-10°, 0°, 15°, and 30°) angles. Muscle length on the paretic group was shorter than the typically developing and nonparetic group for all three muscles (medial and lateral gastrocnemius and soleus muscles) for knee and ankle angles. These results were not statistically significant. Normalized muscle lengths in the dynamic/static status revealed a significant difference in the length of the lateral gastrocnemius muscle between the cerebral palsy and typically developing group. I observed muscle shortening on the paretic side of the children with cerebral palsy. This finding suggests that the recovery of plantar flexor length is the most important issue that must be resolved for normal gait and motor function.
本研究的目的是分析痉挛性偏瘫型脑瘫患儿腓肠肌内侧头、外侧头和比目鱼肌的长度，以定量评估骨骼肌的结构差异。本研究纳入了10例痉挛性脑瘫患儿和10例发育正常的儿童。为了评估脑瘫导致的踝关节跖屈肌长度变化，我们同时采用了步态分析和交互式肌肉骨骼建模软件来模拟骨骼肌长度。利用该模型，在不同的膝关节（0°、45°和90°）和踝关节（-10°、0°、15°和30°）角度下评估腓肠肌内侧头、外侧头和比目鱼肌的长度差异。对于膝关节和踝关节角度，所有三块肌肉（腓肠肌内侧头、外侧头和比目鱼肌）的患侧组肌肉长度均短于发育正常组和非患侧组。这些结果无统计学意义。动态/静态状态下的标准化肌肉长度显示，脑瘫组和发育正常组之间腓肠肌外侧头的长度存在显著差异。我观察到脑瘫患儿患侧肌肉缩短。这一发现表明，恢复跖屈肌长度是实现正常步态和运动功能必须解决的最重要问题。
