González-Matilla Ramón, Abuín-Porras Vanesa, Mínguez-Esteban Isabel, Heredia-Rizo Alberto M
Departamento de Fisioterapia, Investigación y Deporte. Centro Universitario FISIDEC, Universidad de Córdoba, Córdoba, Spain.
Centro de Atención Infantil Temprana, Universidad de Córdoba, Córdoba, Spain.
Front Physiol. 2025 Apr 15;16:1588084. doi: 10.3389/fphys.2025.1588084. eCollection 2025.
Spasticity and altered muscle tone are key features in children with neurodevelopmental disorders, particularly cerebral palsy (CP). They impact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differences in children with CP can help improve clinical assessment and therapeutic interventions. This study aims to evaluate differences in muscle tone, stiffness, ROM, and pain perception between children with CP and typically developing peers using objective biomechanical measures.
An observational, cross-sectional study was conducted with 40 participants of both sexes (20 children with CP, 20 typically developing peers). Muscle tone and stiffness of the lower limb muscles were measured using the Myoton PRO device. ROM was assessed by goniometry, and pain perception was evaluated using the Visual Analog Scale during a Straight Leg Raise (SLR) test. A generalized linear mixed model was used to detect differences in myotonometry, ROM, and pain perception measurements. In participants with CP, the Pearson product-moment correlation coefficient analysis was used to explore possible associations between clinical features and muscle tone and stiffness.
Children with CP exhibited reduced ROM, with a significant group effect for hip flexion (P < 0.001; η = 0.843), knee extension (P < 0.001; η = 0.355), and ankle flexion (P < 0.001; η = 0.959) and higher pain perception during the SLR test (P < 0.001; η = 0.831), compared to controls. Myotonometry revealed significantly increased muscle stiffness of the rectus femoris (P = 0.004; η = 0.112) and adductor muscles (P = 0.019; η2 = 0.074) in the CP group, with no differences in muscle tone between the groups. Sex-related differences were found for muscle tone and stiffness, with males showing higher values. Correlation analyses indicated that adductor muscles stiffness was associated with CP severity.
Children with CP demonstrate significant changes in ROM, pain perception, and muscle stiffness, emphasizing the need for targeted therapeutic interventions. These findings support the use of objective biomechanical tools for assessing muscle properties in clinical settings, contributing to better management strategies for spasticity-related impairments.
痉挛和肌张力改变是神经发育障碍儿童，尤其是脑瘫（CP）患儿的关键特征。它们会影响运动、关节活动范围（ROM）和疼痛感知，进而影响功能能力和生活质量。了解脑瘫患儿内在的肌肉差异有助于改善临床评估和治疗干预。本研究旨在使用客观生物力学测量方法评估脑瘫患儿与发育正常的同龄人在肌张力、僵硬程度、关节活动范围和疼痛感知方面的差异。
对40名男女参与者（20名脑瘫患儿，20名发育正常的同龄人）进行了一项观察性横断面研究。使用Myoton PRO设备测量下肢肌肉的肌张力和僵硬程度。通过量角法评估关节活动范围，并在直腿抬高（SLR）测试期间使用视觉模拟量表评估疼痛感知。使用广义线性混合模型检测肌张力测量、关节活动范围和疼痛感知测量方面的差异。在脑瘫患儿中，使用Pearson积矩相关系数分析来探索临床特征与肌张力和僵硬程度之间的可能关联。
与对照组相比，脑瘫患儿的关节活动范围减小，在髋关节屈曲（P < 0.001；η = 0.843）、膝关节伸展（P < 0.001；η = 0.355）和踝关节屈曲（P < 0.001；η = 0.959）方面有显著的组间效应，并且在SLR测试期间疼痛感知更高（P < 0.001；η = 0.831）。肌张力测量显示，脑瘫组股直肌（P = 0.004；η = 0.112）和内收肌（P = 0.019；η2 = 0.074）的肌肉僵硬程度显著增加，两组之间的肌张力没有差异。发现肌张力和僵硬程度存在性别差异，男性的值更高。相关分析表明，内收肌僵硬程度与脑瘫严重程度相关。
脑瘫患儿在关节活动范围、疼痛感知和肌肉僵硬程度方面表现出显著变化，强调了针对性治疗干预的必要性。这些发现支持在临床环境中使用客观生物力学工具评估肌肉特性，有助于制定更好的痉挛相关损伤管理策略。
