Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy.

Simon Henri Schless, Francesco Cenni, L Bar-On, Britta Hanssen, Marije Goudriaan, E. Papageorgiou, E. Aertbeliën, Guy Molenaers, Kaat Desloovere

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND:
Individuals with spastic cerebral palsy (CP) have neuromotor symptoms contributing towards their gait patterns. However, the role of altered muscle morphology alongside these symptoms is yet to be fully investigated.

RESEARCH QUESTION:
To what extent can medial gastrocnemius and tibialis anterior volume and echo-intensity, plantar/dorsiflexion strength and selective motor control, plantarflexion spasticity and passive ankle dorsiflexion explain abnormal ankle gait.

METHOD:
In thirty children and adolescents with spastic CP (8.6 ± 3.4 y/mo) and ten typically developing peers (9.9 ± 2.4 y/mo), normalised muscle volume and echo-intensity were estimated. Both cohorts also underwent three-dimensional gait analysis, whilst for participants with spastic CP, plantar/dorsi-flexion strength and selective motor control, plantarflexion spasticity and maximum ankle dorsiflexion were also measured. The combined contribution of these parameters towards five clinically meaningful features of gait were evaluated, using backwards multiple regression analyses.

RESULTS:
With respect to the typically developing cohort, the participants with spastic CP had deficits in normalised medial gastrocnemius and tibialis anterior volume of 40% and 33%, and increased echo-intensity values of 19% and 16%, respectively. The backwards multiple regression analyses revealed that the combination of reduced ankle dorsiflexion, muscle volume, plantarflexion strength and dorsiflexion selective motor control could account for 12-62% of the variance in the chosen features of gait.

SIGNIFICANCE:
The combination of altered muscle morphology and neuromotor symptoms partly explained abnormal gait at the ankle in children with spastic CP. Both should be considered as important measures for informed treatment decision-making, but further work is required to better unravel the complex pathophysiology.
Original languageEnglish
Pages (from-to)531-537
Number of pages7
JournalGait and Posture
Volume68
DOIs
Publication statusPublished - 1 Feb 2019

Cite this

Schless, Simon Henri ; Cenni, Francesco ; Bar-On, L ; Hanssen, Britta ; Goudriaan, Marije ; Papageorgiou, E. ; Aertbeliën, E. ; Molenaers, Guy ; Desloovere, Kaat. / Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy. In: Gait and Posture. 2019 ; Vol. 68. pp. 531-537.
@article{754a6e90aa964caf9ee97d0812c67232,
title = "Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy.",
abstract = "BACKGROUND:Individuals with spastic cerebral palsy (CP) have neuromotor symptoms contributing towards their gait patterns. However, the role of altered muscle morphology alongside these symptoms is yet to be fully investigated.RESEARCH QUESTION:To what extent can medial gastrocnemius and tibialis anterior volume and echo-intensity, plantar/dorsiflexion strength and selective motor control, plantarflexion spasticity and passive ankle dorsiflexion explain abnormal ankle gait.METHOD:In thirty children and adolescents with spastic CP (8.6 ± 3.4 y/mo) and ten typically developing peers (9.9 ± 2.4 y/mo), normalised muscle volume and echo-intensity were estimated. Both cohorts also underwent three-dimensional gait analysis, whilst for participants with spastic CP, plantar/dorsi-flexion strength and selective motor control, plantarflexion spasticity and maximum ankle dorsiflexion were also measured. The combined contribution of these parameters towards five clinically meaningful features of gait were evaluated, using backwards multiple regression analyses.RESULTS:With respect to the typically developing cohort, the participants with spastic CP had deficits in normalised medial gastrocnemius and tibialis anterior volume of 40{\%} and 33{\%}, and increased echo-intensity values of 19{\%} and 16{\%}, respectively. The backwards multiple regression analyses revealed that the combination of reduced ankle dorsiflexion, muscle volume, plantarflexion strength and dorsiflexion selective motor control could account for 12-62{\%} of the variance in the chosen features of gait.SIGNIFICANCE:The combination of altered muscle morphology and neuromotor symptoms partly explained abnormal gait at the ankle in children with spastic CP. Both should be considered as important measures for informed treatment decision-making, but further work is required to better unravel the complex pathophysiology.",
author = "Schless, {Simon Henri} and Francesco Cenni and L Bar-On and Britta Hanssen and Marije Goudriaan and E. Papageorgiou and E. Aertbeli{\"e}n and Guy Molenaers and Kaat Desloovere",
year = "2019",
month = "2",
day = "1",
doi = "doi: 10.1016/j.gaitpost.2018.12.002",
language = "English",
volume = "68",
pages = "531--537",
journal = "Gait and Posture",
issn = "0966-6362",
publisher = "Elsevier",

}

Schless, SH, Cenni, F, Bar-On, L, Hanssen, B, Goudriaan, M, Papageorgiou, E, Aertbeliën, E, Molenaers, G & Desloovere, K 2019, 'Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy.' Gait and Posture, vol. 68, pp. 531-537. https://doi.org/doi: 10.1016/j.gaitpost.2018.12.002

Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy. / Schless, Simon Henri; Cenni, Francesco; Bar-On, L; Hanssen, Britta; Goudriaan, Marije; Papageorgiou, E.; Aertbeliën, E.; Molenaers, Guy; Desloovere, Kaat.

In: Gait and Posture, Vol. 68, 01.02.2019, p. 531-537.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Combining muscle morphology and neuromotor symptoms to explain abnormal gait at the ankle joint level in cerebral palsy.

AU - Schless, Simon Henri

AU - Cenni, Francesco

AU - Bar-On, L

AU - Hanssen, Britta

AU - Goudriaan, Marije

AU - Papageorgiou, E.

AU - Aertbeliën, E.

AU - Molenaers, Guy

AU - Desloovere, Kaat

PY - 2019/2/1

Y1 - 2019/2/1

N2 - BACKGROUND:Individuals with spastic cerebral palsy (CP) have neuromotor symptoms contributing towards their gait patterns. However, the role of altered muscle morphology alongside these symptoms is yet to be fully investigated.RESEARCH QUESTION:To what extent can medial gastrocnemius and tibialis anterior volume and echo-intensity, plantar/dorsiflexion strength and selective motor control, plantarflexion spasticity and passive ankle dorsiflexion explain abnormal ankle gait.METHOD:In thirty children and adolescents with spastic CP (8.6 ± 3.4 y/mo) and ten typically developing peers (9.9 ± 2.4 y/mo), normalised muscle volume and echo-intensity were estimated. Both cohorts also underwent three-dimensional gait analysis, whilst for participants with spastic CP, plantar/dorsi-flexion strength and selective motor control, plantarflexion spasticity and maximum ankle dorsiflexion were also measured. The combined contribution of these parameters towards five clinically meaningful features of gait were evaluated, using backwards multiple regression analyses.RESULTS:With respect to the typically developing cohort, the participants with spastic CP had deficits in normalised medial gastrocnemius and tibialis anterior volume of 40% and 33%, and increased echo-intensity values of 19% and 16%, respectively. The backwards multiple regression analyses revealed that the combination of reduced ankle dorsiflexion, muscle volume, plantarflexion strength and dorsiflexion selective motor control could account for 12-62% of the variance in the chosen features of gait.SIGNIFICANCE:The combination of altered muscle morphology and neuromotor symptoms partly explained abnormal gait at the ankle in children with spastic CP. Both should be considered as important measures for informed treatment decision-making, but further work is required to better unravel the complex pathophysiology.

AB - BACKGROUND:Individuals with spastic cerebral palsy (CP) have neuromotor symptoms contributing towards their gait patterns. However, the role of altered muscle morphology alongside these symptoms is yet to be fully investigated.RESEARCH QUESTION:To what extent can medial gastrocnemius and tibialis anterior volume and echo-intensity, plantar/dorsiflexion strength and selective motor control, plantarflexion spasticity and passive ankle dorsiflexion explain abnormal ankle gait.METHOD:In thirty children and adolescents with spastic CP (8.6 ± 3.4 y/mo) and ten typically developing peers (9.9 ± 2.4 y/mo), normalised muscle volume and echo-intensity were estimated. Both cohorts also underwent three-dimensional gait analysis, whilst for participants with spastic CP, plantar/dorsi-flexion strength and selective motor control, plantarflexion spasticity and maximum ankle dorsiflexion were also measured. The combined contribution of these parameters towards five clinically meaningful features of gait were evaluated, using backwards multiple regression analyses.RESULTS:With respect to the typically developing cohort, the participants with spastic CP had deficits in normalised medial gastrocnemius and tibialis anterior volume of 40% and 33%, and increased echo-intensity values of 19% and 16%, respectively. The backwards multiple regression analyses revealed that the combination of reduced ankle dorsiflexion, muscle volume, plantarflexion strength and dorsiflexion selective motor control could account for 12-62% of the variance in the chosen features of gait.SIGNIFICANCE:The combination of altered muscle morphology and neuromotor symptoms partly explained abnormal gait at the ankle in children with spastic CP. Both should be considered as important measures for informed treatment decision-making, but further work is required to better unravel the complex pathophysiology.

U2 - doi: 10.1016/j.gaitpost.2018.12.002

DO - doi: 10.1016/j.gaitpost.2018.12.002

M3 - Article

VL - 68

SP - 531

EP - 537

JO - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

ER -