Effect of serial casting in spastic cerebral palsy

Jain, Shweta; Mathur, Navnendra; Joshi, Mrinal; Jindal, Rajeshwari; Goenka, Sunil

doi:10.1007/s12098-008-0100-z

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…The measurement of muscle thickness with ultrasound may provide an alternative method of quantitative muscle evaluation (Ohata et al, 2006). Furthermore, clinical therapies often applied in children with cerebral palsy, such as botulinum toxin injections into the gastrocnemius muscle (Eames et al, 1999), gastrocnemius recession to lengthen the musculotendinous unit or cast immobilization of the ankle in a dorsi-flexed position (Jain et al, 2008), are expected to have implications for muscle architecture. Yet, the treatment outcome regarding muscle architecture is rarely documented and not standard in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Variation and reliability of ultrasonographic quantification of the architecture of the medial gastrocnemius muscle in young children

Legerlotz

Smith

Hing

2010

Clin Physio Funct Imaging

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The aim of this study was to evaluate the suitability of ultrasonography for the quantification of gastrocnemius muscle architecture in healthy young children. The variation and reliability of measurement of muscle thickness, pennation angle and fibre length of the medial gastrocnemius were determined, using stationary and portable ultrasound machines, in 13 boys and eight girls aged 4-10. Ultrasound images were obtained from each leg, in duplicate, with the ankle at 90 degrees , then at maximal plantar flexion, with the two machines within the same session. The same set of 16 scans was repeated in four children 4-6 weeks later. The mean muscle thickness, pennation angle and fibre length differed between ankle positions and between legs. Measurements obtained using the two machines established similar values with no significant differences in absolute values and coefficients of variation (CV). For duplicate images taken during the same session for the same leg, ankle position and machine, the CV and intraclass correlation coefficients (ICC) ranged, respectively, from 2.1% to 3.1% and 0.94-0.98 for muscle thickness, from 4.1% to 6.0% and 0.85-0.96 for pennation angle and from 4.5% to 6.3% and 0.87-0.96 for fibre length. Corresponding values for variables for the same child measured on two separate occasions were within the same ranges, all being similar to reliability data reported previously for adult muscle. Muscle thickness, pennation angle and fibre length of the medial gastrocnemius can therefore be quantified reliably, using either a stationary or portable ultrasound machine, in healthy young children.

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Section: Introductionmentioning

confidence: 99%

Variation and reliability of ultrasonographic quantification of the architecture of the medial gastrocnemius muscle in young children

Legerlotz

Smith

Hing

2010

Clin Physio Funct Imaging

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“…6 Physical treatment such as casting also aims at diminishing spasticity and promoting range of movement in the joints. 7,8 A fundamental problem with all these therapies is that neural mechanisms (i.e. spasticity) are not the only causes of increased muscle tone.…”

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confidence: 99%

Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity

Willerslev-Olsen

Lorentzen

Sinkjær

et al. 2013

Develop Med Child Neuro

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AIM Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (CP) receive antispasticity treatment unnecessarily. To investigate this, we aimed to determine the contribution of reflex mechanisms to changes in the passive elastic properties of muscles and tendons in children with CP.METHOD Biomechanical and electrophysiological measures were used to determine the relative contribution of reflex and passive mechanisms to ankle muscle stiffness in 35 children with spastic CP (21 males, 14 females; mean age 9y, SD 3y 4mo; range 3-15y) and 28 control children without CP (19 males, nine females; mean age 8y 11mo, SD 2y 10mo; range 3-15y). Twenty-seven children were diagnosed as having spastic hemiplegia, six with spastic diplegia, and two with spastic tetraplegia. According to the Gross Motor Function Classification System, 31 children were classified in level I, two in level II, and two in level III.RESULTS Only seven children with spastic CP showed reflex stiffness outside the range of the control children. In contrast, 20 children with spastic CP showed abnormal passive muscle stiffness (p<0.001). No correlation between increased reflex or increased passive muscle stiffness and age was observed within the age range studied.

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“…On the other hand, casting works mainly on muscle contracture, and therefore, cast application might be helpful for gaining additional ROM in cases in which there is muscle contracture 13,24. In particular, two kinds of cast application were used in the literature for managing equinus in the children with CP.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy

et al. 2010

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PurposeThe purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot.Materials and MethodsChildren in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection. Assessments were performed before the intervention and 1 month after the intervention.ResultsAfter the intervention, there were significant improvements in tone, dynamic spasticity, and passive range of motion (ROM) in both groups. However, the changes were greater in group A than in group B. Dimension D (standing) in Gross Motor Function Measure (GMFM)-66 was significantly improved in group A but not in group B. On the other hand, there were no significant changes in di-mension E (walking, running, jumping) in GMFM-66 in either group.ConclusionThe results of our study suggest that a serial casting application after BTX-A injection can enhance the benefits of BTX-A injection in children with cerebral palsy.

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Effect of serial casting in spastic cerebral palsy

Abstract: Thus serial casting is a very simple, safe and cost effective procedure which can be applied even in children with mental sub normality having all three major joints involved bilaterally.

Cited by 16 publications

References 24 publications

Variation and reliability of ultrasonographic quantification of the architecture of the medial gastrocnemius muscle in young children

Variation and reliability of ultrasonographic quantification of the architecture of the medial gastrocnemius muscle in young children

Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity

Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy

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