Hamstring length, gross motor function and gait in children and adolescents with cerebral palsy

Authors

DOI:

https://doi.org/10.1590/1809-2950/18018026042019

Keywords:

Gait, Cerebral Palsy, Musculoskeletal System;, Motor Activity

Abstract

This study aims at assessing the relationship between hamstring length, gross motor function, and gait in children with spastic cerebral palsy (CP). Children and adolescents aged between 6 and 18 years, were classified as levels I, II or III according to the Gross Motor Function Classification System. Participants were assessed using a modified Tardieu Scale to determine hamstring length, evaluating: R1 (first leg extension resistance), R2 (second leg extension resistance) and R2-R1 (difference between R1 and R2) of the left and right lower limbs. The Gross Motor Function Measure (GMFM) was used to evaluate gross motor function and the modified Physicians Rating Scale (PRS) for gait. Twenty-three participants were included in the study and the results showed a moderate correlation between R1, R2, and PRS of the left leg and the GMFM. All other variables exhibited a weak correlation. Hamstring length was weakly to moderately related to gross motor function and gait in children and adolescents with CP.

Downloads

Download data is not yet available.

References

Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M,

Damiano D, et al. A report: the definition and classification

of cerebral palsy April 2006. Dev Med Child Neurol Suppl.

;49(109):8-14. doi: 10.1111/j.1469-8749.2007.tb12610.x

Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano

DL, et al. Cerebral palsy. Nat Rev Dis Primers. 2016;2:15082.

doi: 10.1038/nrdp.2015.82

Herskind A, Greisen G, Nielsen JB. Early identification

and intervention in cerebral palsy. Dev Med Child Neurol.

;57(1):29-36. doi: 10.1111/dmcn.12531

Van Der Krogt MM, Bar-On L, Kindt T, Desloovere K, Harlaar J.

Neuro-musculoskeletal simulation of instrumented contracture

and spasticity assessment in children with cerebral palsy.

J Neuroeng Rehabil. 2016;13(1):64. doi: 10.1186/s12984-016-0170-5

Parent A, Pouliot-Laforte A, Dal MF, Cherni Y, Marois P, Ballaz

L. Muscle fatigue during a short walking exercise in children

with cerebral palsy who walk in a crouch gait. Gait Posture.

;72:22-7. doi: 10.1016/j.gaitpost.2019.05.021

Feger MA, Lunsford CD, Sauer LD, Novicoff W, Abel MF.

Comparative effects of multilevel muscle tendon surgery,

osteotomies, and dorsal rhizotomy on functional and gait

outcome measures for children with cerebral palsy. PM R.

;7(5):485-93. doi: 10.1016/j.pmrj.2014.11.002

Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi

B. Development and reliability of a system to classify gross

motor function in children with cerebral palsy. Dev Med

Child Neurol. 1997;39(4):214-23. doi: 10.1111/j.1469-8749.1997.

tb07414.x

Palisano R, Rosenbaum P, Bartlett D, Livingston MH. Gross

motor function classification system: expanded and revised.

Hamilton: McMaster University; 2007.

Hiratuka E, Matsukura TS, Pfeifer LI. Cross-cultural adaptation

of the gross motor function classification system into BrazilianPortuguese (GMFCS). Rev Bras Fisioter. 2010;14(6):537-44. doi:

1590/S1413-35552010000600013

Almeida KM, Fonseca BM, Gomes AA, Oliveira MX. Factors

influencing the quality of life of caregivers of cerebral

palsy children. Fisioter Mov. 2013;26(2):307-14. doi: 10.1590/

S0103-51502013000200007

Boyd RN, Graham HK. Objective measurement of clinical findings

in the use of botulinum toxin type A for the management of

children with cerebral palsy. Eur J Neurol. 1999;6(4):23-35. doi:

1111/j.1468-1331.1999.tb00031.x

Cury VCR, Mancini MC, Melo AP, Fonseca ST, Sampaio RF,

Tirado MGA. The effects of the use of orthoses on the functional

mobility of children with cerebral palsy. Braz J Phys Ther.

;10(1):67-74. doi: 10.4322/2526-8910.ctoao1612

Olesch CA, Greaves S, Imms C, Reid SM, Graham HK. Repeat

botulinum toxin-A injections in the upper limb of children

with hemiplegia: a randomized controlled trial. Dev Med Child

Neurol. 2010;52(1):79-86. doi: 10.1111/j.1469-8749.2009.03387

Gracies JM, Burke K, Clegg NJ, Browne R, Rushing C, Fehlings

D, et al. Reliability of the Tardieu scale for assessing spasticity

in children with cerebral palsy. Arch Phys Med Rehabil.

;91(3):421-8. doi: 10.1016/j.apmr.2009.11.017

Numanoglu A, Gunel MK. Intraobserver reliability of modified

Ashworth scale and modified Tardieu scale in the assessment of

spasticity in children with cerebral palsy. Acta Orthop Traumatol

Turc. 2012;46(3):196-200.

Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross motor

function measure (GMFM-66 & GMFM-88): user’s manual.

London: Mac Keith Press; 2002.

Russell D, Rosenbaum PL, Avery LM, Lane M. Medida da função

motora grossa (GMFM-66 & GMFM-88): manual do usuário.

nd ed. São Paulo: Mennom; 2011.

Almeida KM, Albuquerque KA, Ferreira ML, Aguiar SKB, Mancini

MC. Reliability of the Brazilian Portuguese version of the gross

motor function measure in children with cerebral palsy. Braz

J Phys Ther. 2016;20(1):73-80. doi: 10.1590/bjpt-rbf.2014.0131

Portney LG, Walkins MP. Foundations of clinical research:

applications to practice. 2nd ed. New Jersey: Prentice Hall

Health; 2000.

Abel MF, Damiano DL, Pannunzio M, Bush J. Muscle-tendon

surgery in diplegic cerebral palsy: functional and mechanical

changes. J Pediatr Orthop. 1999;19(3):366-75.

Laracca E, Stewart C, Postans N, Roberts A. The effects of

surgical lengthening of hamstring muscles in children with

cerebral palsy: the consequences of pre-operative muscle

length measurement. Gait Posture. 2014;39(3):847-51. doi:

1016/j.gaitpost.2013.11.010

Mutlu A, Bugusan S, Kara OK. Impairments, activity limitations,

and participation restrictions of the international classification

of functioning, disability, and health model in children with

ambulatory cerebral palsy. Saudi Med J. 2017;38(2):176-85.

doi: 10.15537/smj.2017.2.16079

Ko IH, Kim JH, Lee BH. Relationship between lower limb

muscle structure and function in cerebral palsy. J Phys Ther

Sci. 2014;26(1):63-6. doi: 10.1589/jpts.26.63

Craig J, Hilderman C, Wilson G, Misovic R. Effectiveness

of stretch interventions for children with neuromuscular

disabilities: evidence-based recommendations. Pediatr Phys

Ther. 2016;28(3):262-75. doi: 10.1097/PEP.0000000000000269

Pin T, Dyke P, Chan M. The effectiveness of passive stretching

in children with cerebral palsy. Dev Med Child Neurol.

;48(10):855-62

Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N,

et al. A systematic review of interventions for children with

cerebral palsy: state of the evidence. Dev Med Child Neurol.

;55(10):885-910. doi: 10.1111/dmcn.12246

Published

2019-08-07

Issue

Section

Original Research

How to Cite

Hamstring length, gross motor function and gait in children and adolescents with cerebral palsy. (2019). Fisioterapia E Pesquisa, 26(4), 366-372. https://doi.org/10.1590/1809-2950/18018026042019