Modulation of Soleus H-Reflexes During Gait in Children With Cerebral Palsy

Hodapp, M.; Klisch, Cornelia; Mall, Volker; Vry, Julia; Berger, W.; Faist, Michael

doi:10.1152/jn.00471.2007

Cited by 45 publications

(39 citation statements)

References 22 publications

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“…It's worth mentioning that the high variability of values for all joints among children with diplegic CP were also observed in the study by Stott et al (2) and lead to consider an immaturity of movements, corroborating the findings of Hodapp et al (33) and Prosser et al (15). Immaturity in the gait for the DG would be a consequence of encephalic lesion and inhibition of the tonic muscular development that occurs over the children's growth (33).…”

Section: Angular Variablessupporting

confidence: 74%

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Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

2017

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Introduction: Diplegic children have difficulties in gait and therefore ramps are used as strategies of accessibility. Objective: The present study investigated the influence of an inclined surface (ascending and descending) on the kinematic characteristics during gait of the diplegic group (DG) when compared to typically developing children of the control group (CG). Methods: Study participants included 20 children (10 with DG and 10 CG) matched by age, which were evaluated in three experimental conditions (horizontal and inclined ascending and inclined descending surfaces of 7º) through an optoelectronic imaging system. Results: Among the linear kinematic variables, only step width differed among groups, however, without influence of the surface. The foot height differed among the groups only in the descending phase, where DG had greater difficulty in raising the foot. The 3-dimensional gait analyses could not provide more evidences of differences in kinematics variables, especially in transverse plane, between DG and CG, but provide some evidence to support that hip range of motion (ROM) during the gait cycle, hip flexion-extension in initial contact, knee ROM and the 2nd anterior-posterior trunk peak amplitude of the DG were influenced on descent by their flexor pattern. Conclusion: The DG was most affected by the inclination plane than CG especially on descent. Although a hip and knee flexor pattern is evident for DG on inclination of 7º, this angle is accessible since it allows independent gait functional activity.

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Section: Angular Variablessupporting

confidence: 74%

“…Immaturity in the gait for the DG would be a consequence of encephalic lesion and inhibition of the tonic muscular development that occurs over the children's growth (33).…”

Section: Angular Variablesmentioning

confidence: 99%

Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

2017

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“…In contrast to control children, there was no correlation between age and stretch reflex size in the children with CP. Hodapp et al (2007b) similarly observed that the soleus H reflex evoked in stance during gait did not show an age-related reduction as in control children. As they suggested, this may reflect a lack of maturation of the corticospinal tract in the children with CP.…”

Section: Age-related Decline In M1 Response Late In Stance In Controlmentioning

confidence: 53%

Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy

Willerslev-Olsen

Andersen

Sinkjær

et al. 2014

Journal of Neurophysiology

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Willerslev-Olsen M, Andersen JB, Sinkjaer T, Nielsen JB. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy. J Neurophysiol 111: 746 -754, 2014. First published November 13, 2013 doi:10.1152/jn.00372.2013.-It is still widely believed that exaggerated stretch reflexes and increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). However, no study has directly measured stretch reflex activity during gait in these children. We investigated sensory feedback mechanisms during walking in 20 CP children and 41 control children. Stretch responses in plantar flexor muscles evoked in stance showed an age-related decline in control but not CP children. In swing the responses were abolished in control children, but significant responses were observed in 14 CP children. This was related to reduced activation of dorsiflexors in swing. Removal of sensory feedback in stance produced a drop in soleus activity of a similar size in control and CP children. Soleus activity was observed in swing to the same extent in control and CP children. Removal of sensory feedback in swing caused a larger drop in soleus activity in control children than in CP children. The lack of age-related decline in stretch reflexes and the inability to suppress reflexes in swing is likely related to lack of maturation of corticospinal control in CP children. Since soleus activity was not seen more frequently than in control children in swing and since sensory feedback did not contribute more to their soleus activity, spasticity is unlikely to contribute to foot drop and toe walking. We propose that altered central drive to the ankle muscles and increased passive muscle stiffness are the main causes of foot drop and toe walking. age-dependent changes; stretch reflex; biomechanical evaluation; cerebral palsy; electrophysiology; spasticity THE MAJORITY OF CHILDREN with cerebral palsy (CP) have gait problems, which impact their quality of life (af Klint et al.

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“…Other evidence of corticospinal tract damage demonstrated that children with CP do not show the tonic suppression of H-reflexes during the stance phase in gait observed in children developing typically [20]. The suppression of the H-reflex happens as the corticospinal tract matures, and it has been hypothesized that the immature pattern persists in children with CP due to corticospinal tract damage [20].…”

Section: Central Sitesmentioning

confidence: 99%

“…The suppression of the H-reflex happens as the corticospinal tract matures, and it has been hypothesized that the immature pattern persists in children with CP due to corticospinal tract damage [20]. In a laboratory setting, individuals with CP may appear less fatigable than the general population as a result of the inability of the descending tracts to fully transmit the signal to the muscles needed to produce a maximal contraction.…”

Section: Central Sitesmentioning

confidence: 99%

Fatigue in cerebral palsy: A critical review

Brunton

Rice

2012

Developmental Neurorehabilitation

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Objective: Fatigue contributes to the deterioration or cessation of walking ability in adults with cerebral palsy (CP). However, conflict exists as to its role. Studies involving functional tasks reported increased, and earlier onset of, fatigue in CP whereas laboratory studies have reported individuals with CP to be more fatigue resistant than their peers.Methods: A critical review of the literature related to fatigue in CP was conducted.Results: This review describes factors that contribute to the observed fatigue resistance in laboratory tasks and how a decreased force-production in CP can result in higher energy expenditure to perform the same amount of work as their peers. Conclusion:More research regarding the process of fatigue and recovery for individuals with CP is needed; specifically studies that focus on functional movements requiring the integration of the whole body, thereby stressing the neuromuscular system in a different way than previously explored.

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Modulation of Soleus H-Reflexes During Gait in Children With Cerebral Palsy

Abstract: Hodapp M, Klisch C, Mall V, Vry J, Berger W, Faist M. Modulation of soleus H-reflexes during gait in children with cerebral palsy.

Cited by 45 publications

References 22 publications

Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy

Fatigue in cerebral palsy: A critical review

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