Elnaggar Ragab K, Alghamdi Mohammed S, Alenazi Aqeel M, Alghadier Mshari, Mahmoud Mustafa Z, Elsayed Abbas Elbakry A, Hassan Ismail Abdelfattah M, Abonour Asmaa A
Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia.
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt.
Children (Basel). 2022 Oct 22;9(11):1604. doi: 10.3390/children9111604.
To investigate how plyometric exercise (PLYO-Ex) affects mechanics and morphometrics of the plantar flexor musculotendinous unit in children with unilateral cerebral palsy, 38 participants (aged 10-16 years) were allocated at random to either the PLYO-Ex group ( = 19; received 24 sessions of plyometric muscle loading, conducted 2 times a week for 3 months in succession) or the control group ( = 19; underwent traditional physical therapy for the same frequency and duration). Measurements were taken pre- and post-intervention. Standard ultrasound imaging was applied to evaluate morphometrics of the gastrocnemius muscle and Achilles tendon unit and an isokinetic dynamometer was used to evaluate maximum voluntary isometric plantar flexors contraction (IVC). With controlling for pre-treatment values, significant post-treatment changes favoring the PLYO-Ex group were observed for morphological (tendon ( = 0.003, = 0.23) length; belly length ( = 0.001, = 0.27); tendon thickness ( = 0.035, = 0.35); muscle thickness ( = 0.013, = 0.17); fascicle length ( = 0.009, = 0.18); pennation angle ( = 0.015, = 0.16)) and mechanical and material properties (IVC ( = 0.009, = 0.18); tendon's elongation ( = 0.012, = 0.17), stiffness ( = 0.027, = 0.13); stress ( = 0.006, = 0.20); strain ( = 0.004, = 0.21)). In conclusion, plyometric exercise induces significant adaptations within the musculotendinous unit of the plantar flexors in children with unilateral cerebral palsy. These adaptations could improve muscular efficiency and consequently optimize physical/functional performance.
为了研究增强式运动（PLYO-Ex）如何影响单侧脑瘫患儿跖屈肌肌腱单位的力学和形态学指标，38名参与者（年龄10 - 16岁）被随机分配到PLYO-Ex组（n = 19；接受24次增强式肌肉负荷训练，连续3个月每周进行2次）或对照组（n = 19；接受相同频率和时长的传统物理治疗）。在干预前后进行测量。应用标准超声成像评估腓肠肌和跟腱单位的形态学指标，使用等速测力计评估最大自主等长跖屈收缩（IVC）。在控制治疗前数值的情况下，观察到治疗后有利于PLYO-Ex组的显著变化，包括形态学指标（肌腱长度（t = 0.003，p = 0.23）；肌腹长度（t = 0.001，p = 0.27）；肌腱厚度（t = 0.035，p = 0.35）；肌肉厚度（t = 0.013，p = 0.17）；肌束长度（t = 0.009，p = 0.18）；羽状角（t = 0.015，p = 0.16））以及力学和材料特性（IVC（t = 0.009，p = 0.18）；肌腱伸长（t = 0.012，p = 0.17），刚度（t = 0.027，p = 0.13）；应力（t = 0.006，p = 0.20）；应变（t = 0.004，p = 0.21））。总之，增强式运动可在单侧脑瘫患儿的跖屈肌肌腱单位内引起显著适应性变化。这些适应性变化可提高肌肉效率，从而优化身体/功能表现。
