The Range of Motion of Long Term Knee Contractures of Four Spastic Cerebral Palsied Children:

McPherson, James J.; Arends, Trese Gallagher; Michaels, Mary; Trettin, Karen

doi:10.1080/j006v04n01_04

Cited by 8 publications

(28 citation statements)

References 18 publications

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“…Previous research investigating stretching in human populations has demonstrated increases in joint range of motion (ROM) (McPherson et al, 1984;Miedaner and Renander, 1987), and decreased joint stiffness in response to long-term stretching (Kubo, et al, 2002;McPherson et al, 1984;Nakamura et al, 2012;O'Dwyer et al, 1994). Often, such decreases in MTU stiffness are interpreted to be reflective of changes in muscle stiffness.…”

Section: Introductionmentioning

confidence: 99%

Does long-term passive stretching alter muscle–tendon unit mechanics in children with spastic cerebral palsy?

Theis

Korff

Mohagheghi

2015

Clinical Biomechanics

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DisclaimerThe University of Gloucestershire has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material.The University of Gloucestershire makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited.The University of Gloucestershire makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights.The University of Gloucestershire accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT. AbstractBackground: Cerebral Palsy causes motor impairments during development and many children may experience excessive neural and mechanical muscle stiffness. The clinical assumption is that excessive stiffness is thought to be one of the main reasons for functional impairments in cerebral palsy. As such, passive stretching is widely used to reduce stiffness, with a view to improving function. However, current research evidence on passive stretching in cerebral palsy is not adequate to support or refute the effectiveness of stretching as a management strategy to reduce stiffness and/or improve function. The purpose was to identify the effect of six weeks passive ankle stretching on muscle-tendon unit parameters in children with spastic cerebral palsy.Methods: Thirteen children (8-14 y) with quadriplegic/diplegic cerebral palsy were randomly assigned to either an experimental group (n=7) or a control group (n=6). The experimental group underwent an additional six weeks of passive ankle dorsiflexion stretching for 15 minutes (per leg), four days per week, whilst the control group continued with their normal routine, which was similar for the two groups. Measures of muscle and tendon stiffness, strain and resting length were acquired pre and post intervention.Findings: The experimental group demonstrated a 3° increase in maximum ankle dorsiflexion. This was accompanied by a 13% reduction in triceps surae muscle stiffness, with no change in tendon stiffness. Additionally, there was an increase in fascicle strain with no changes in resting length, suggesting muscle stiffness reductions were a result of alterations in intra/extra-muscular connective tissue.Interpretation: The results demonstrate that stretching can reduce muscle stiffness by altering fascicle strain but not resting fascicle length.

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Section: Introductionmentioning

confidence: 99%

Does long-term passive stretching alter muscle–tendon unit mechanics in children with spastic cerebral palsy?

Theis

Korff

Mohagheghi

2015

Clinical Biomechanics

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“…Straight leg raising on the right side was greater under the 5-day-per-week condition than under the twice-a-week condition. As was the case in the study by McPherson et al, 7 participants received positioning and bracing in the classroom and PROM exercises at home throughout the study, which makes the contribution of the PROM exercises unclear.…”

mentioning

confidence: 99%

“…7,19 In both studies, the PROM exercises consisted of moving an extremity passively to the end of the PROM and holding this position for 20 to 60 seconds, then repeating this stretch 5 times. Researchers studying people with and without neuromusculoskeletal impairments have found that one 30-second stretch 5 days a week is as effective in increasing hamstring muscle length as one 60-second stretch or three 30-or 60-second stretches.…”

Section: Passive Range Of Motion Programmentioning

confidence: 99%

“…1 Contracture, as it relates to cerebral palsy, has been defined in several ways, including permanent contraction of a muscle, 2 high resistance to passive stretch, 2 hypoextensibility, 3,4 diminished range of passive stretch, 5 and intrinsic muscle shortening that prevents full range of motion. 6 Many interrelated factors have been proposed to cause contractures in people with cerebral palsy, including more activation of muscles on one side of a joint than on the other side, 4 changes in connective tissue and muscle length, 7,8 slow muscle growth, 4 and positioning. 9 People with spastic cerebral palsy who do not walk and whose voluntary movement is restricted to the extent that they cannot independently move their joints through the full range of motion during daily activities are at particularly high risk for developing a contracture.…”

mentioning

confidence: 99%

“…10,11 In 2 studies, researchers found at least minimal benefits to PROM exercises for young people with cerebral palsy. 7,19 Over a 2-year period, McPherson et al 7 examined the effects of PROM exercises and positioning on knee flexion contractures of 4 participants between 10 to 18 years of age. During the first year of the study, the participants received PROM exercises 3 times a day at school and twice a week at home.…”

mentioning

confidence: 99%

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Effect of Passive Range of Motion Exercises on Lower-Extremity Goniometric Measurements of Adults With Cerebral Palsy: A Single-Subject Design

Cadenhead¹,

McEwen

Thompson

2002

Physical Therapy

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Background and Purpose. People with spastic cerebral palsy often receive passive stretching that is intended to maintain or increase joint passive range of motion (PROM) even though the effectiveness of these exercises has not been definitively demonstrated. The purpose of this study was to determine the effect of PROM exercises on 6 adults with spastic quadriplegia and contractures. Participants. Four men and 2 women (Xϭ31 years of age, rangeϭ20 -44 years) who lived in an institution for people with mental retardation participated in the study. Methods. The authors used 2 multiple baseline designs. Three participants (group 1) received lower-extremity PROM exercises during phase A; PROM exercises were discontinued during phase B. Three participants (group 2) did not receive PROM exercises during phase A; PROM exercises were initiated during phase B. Data were analyzed using visual analysis and the C statistic. Results. Results varied with the method of analysis; however, phase A and phase B measurements, overall, did not differ for either group. Discussion and Conclusion. This study demonstrated use of a single-subject design to measure the effect of PROM exercises on adults with cerebral palsy. The authors concluded that the PROM exercise protocol did not have an effect on the lower-extremity goniometric measurements of the participants.[Cadenhead SL, McEwen IR, Thompson DM. Effect of passive range of motion exercises on lower-extremity goniometric measurements of adults with cerebral palsy: a single-subject design. Phys Ther. 2002;82:658 -669.]

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How Does Spasticity Affect Patients with Disorders of Consciousness?

Martens

Foidart-Dessalle

Laureys

et al. 2017

Coma and Disorders of Consciousness

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Spasticity is a frequent issue encountered by brain-damaged patients, arising from an anarchic reorganization of the central nervous system that may significantly alter motor function. While it is well described in patients with a lesion of the descending corticospinal system, little is known about the occurrence and physiopathology of this disorder in patients with more complex brain lesions and disorders of consciousness (coma, unresponsive wakefulness syndrome, and minimally conscious state). Most of the time, these patients are bedridden and lack voluntary motor command which favors spasticity to occur and may lead to complications including pain, loss in range of motion, or bed sores. Given the inability for many of these patients to express their pain or discomfort and knowing that spastic syndromes may restrain them to express signs of consciousness, the multimodal treatment of this spasticity is crucial for their management. In the present chapter, we describe the physiopathology and the current available treatments of spasticity in this specific population of severe brain-injured patients with disorders of consciousness.

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The Range of Motion of Long Term Knee Contractures of Four Spastic Cerebral Palsied Children:

Cited by 8 publications

References 18 publications

Does long-term passive stretching alter muscle–tendon unit mechanics in children with spastic cerebral palsy?

Does long-term passive stretching alter muscle–tendon unit mechanics in children with spastic cerebral palsy?

Effect of Passive Range of Motion Exercises on Lower-Extremity Goniometric Measurements of Adults With Cerebral Palsy: A Single-Subject Design

How Does Spasticity Affect Patients with Disorders of Consciousness?

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