1. What causes increased passive stiffness of plantarflexor muscle–tendon unit in children with spastic cerebral palsy?
- Author
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Vincent Gautheron, Raphaël Gross, Clément Boulard, Thomas Lapole, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,animal structures ,Adolescent ,Physiology ,[SDV]Life Sciences [q-bio] ,Cerebral palsy ,Tendons ,03 medical and health sciences ,0302 clinical medicine ,Spastic cerebral palsy ,Physical medicine and rehabilitation ,Elastic Modulus ,Physiology (medical) ,medicine ,Spastic ,Humans ,Orthopedics and Sports Medicine ,Child ,Muscle, Skeletal ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Cerebral Palsy ,Public Health, Environmental and Occupational Health ,Stiffness ,Muscle belly ,030229 sport sciences ,General Medicine ,Muscle stiffness ,equipment and supplies ,medicine.disease ,Tendon ,medicine.anatomical_structure ,Muscle Spasticity ,Ankle ,medicine.symptom ,Contracture ,business ,030217 neurology & neurosurgery - Abstract
The term ‘stiffness’ is commonly used in the literature to refer to various components of ‘hyperresistance’ by which spastic muscles oppose to their passive lengthening, especially in children with cerebral palsy (CP). Originally, stiffness consists of mechanical resistance to passive movement in the absence of any muscle activation. Increased muscle stiffness in CP therefore refers to alterations to the mechanical properties of the tissue. It is closely linked to muscle shortening, yet the two phenomena are not equivalent. Both increased stiffness and shortening are present early in childhood in the plantarflexor muscles of children with spastic CP. This narrative review provides a comprehensive overview of the literature on passive stiffness of the plantarflexor muscles measured at the joint, muscles, fascicles, and fiber level in children with CP. Articles were searched through the Pub’Med database using the keywords “cerebral palsy” AND “stiffness”. The ambiguous use of the term ‘stiffness’ has been supported by discrepancies in available results, influenced by heterogeneity in materials, methodologies and characteristics of the participants among studies. Increased stiffness at the joint and muscle belly level may be explained by altered structural properties at the microscopic level. This thorough investigation of the literature suggests that the pathophysiology and the time course of the development of stiffness and contracture remain to be elucidated. A consideration of both morphological and mechanical measurements in children with CP is important when describing the alterations in their plantarflexors.
- Published
- 2019