Serebral palsili çocuklarda spastisitenin myotonometri ile değerlendirilmesi ve spastisitede elektrik stimulasyonun etkinliği

Abstract

ÖzPurpose: The aim of this study was to evaluate the biomechenical properties (tone, elasticity, stifness) of gastrocnemius muscle (GCM) using myotonometry in children with spastic cerebral palsy (CP) and to demonstrate therapeutic effectiveness of electrical stimulation onmuscle tone, elasticity and stiffness. Materials and Methods: Forty patients with spastic CP (11 diplegic, 16 quadriplegic, 13 hemiplegic) and 20 age, gender and body mass index matched healthy controls were evaluated. MyotonPro was used to measure the medial and lateral GCM on bilateral sides of diplegic/quadriplegic patiens and healthy controls,and from the paretic side of the hemiplegic patients. Spasticity was evaluated by Ashworth Scale and functional level was assessed by Gross Motor Function Classification System.The measurements of 66 extremities of 40 patients were compared with 40 extremities of 20 controls. Results: Eighteen patients (31 extremities) with spastic CP were treated for 5 days of electrical stimulation which was applied on GCM. The muscle tone and stiffness of medial and lateral GCM decreased and the elasticity values increased significantly after the intervention. Although Ashworth scores were also decreased, no correlations between Ashworth scores and myotonometric values were detected. Conclusion: Our results suggest that electrical stimulation for the treatment of spasticity had improvements on muscle tone, elasticity and stiffness. MyotonPro can be used to measure the effects of treatment in spasticity.

Evaluation of the Viscoelastic Properties of Lower-Extremity Muscles of Pediatric Hemophilia Patients Using Myotonometric Measurements

“…In the GM muscle, while elasticity was similar between the two groups, tone and stiffness showed worse results in the CP group. In our study, when we looked at the GM and GL measurement results in the hemophilia group, tone was higher and elasticity was lower, but there were no significant differences between the groups [17]. Hemarthroses occur in the knee in 60% of patients with hemophilia, affecting the biomechanical alignment of the lower extremity [27].…”

“…MyotonPRO has been used to evaluate mechanical properties in healthy individuals [12], athletes [13], and geriatric individuals [14], and various diseases [15,16]. However, in the pediatric group, myotonometric measurements are frequently preferred in diseases such as cerebral palsy, brachial plexus injury, and in children with developmental delays [17][18][19][20]. To date, no study has been found to investigate the changes in the viscoelastic properties of the lower-extremity muscles in pediatric hemophilia patients.…”