Intra-operatively measured spastic semimembranosus forces of children with cerebral palsy |
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| Affiliation: | 1. Institute of Biomedical Engineering, Boğaziçi University, Istanbul, Turkey;2. Istanbul School of Medicine, Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey;1. Department of Health, Sport, and Exercise Sciences, Neuromechanics Laboratory, University of Kansas, Lawrence, KS, USA;2. Exercise Science Department, Creighton University, Omaha, NE, USA;3. Department of Exercise and Sport Science, Neuromuscular Research Laboratory, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA;4. Exercise and Sport Science Department, University of Wisconsin-La Crosse, La Crosse, WI, USA;5. Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA;6. Department of Health and Human Performance, Oklahoma State University, Stillwater, OK, USA;7. Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA;1. Medical Physics Group, Institute of Diagnostic and Interventional Radiology I, Jena University Hospital – Friedrich Schiller University Jena, Germany;2. Medical Engineering and Biotechnology, Jena University of Applied Sciences (EAH Jena), Germany;1. Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan;2. School of Rehabilitation, Université de Montréal, 7077 Avenue du Parc, Montréal, Quebec H3C 3J7, Canada;3. Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of the Institut de réadaptation Gingras-Lindsay-de-Montréal, 6300 Avenue du Darlington, Montréal, Quebec H3S 2J4, Canada;4. Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada;5. Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, 520 Sutherland Drive, Toronto, Ontario M4G 3V9, Canada |
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| Abstract: | The knee kept forcibly in a flexed position is typical in cerebral palsy. Using a benchmark, we investigate intra-operatively if peak spastic hamstring force is measured in flexed knee positions. This tests the assumed shift of optimal length due to adaptation of spastic muscle and a decreasing force trend towards extension. Previously we measured spastic gracilis (GRA) and semitendinosus (ST) forces. Presently, we studied spastic semimembranosus (SM) and tested the following hypotheses: spastic SM forces are (1) high in flexed and (2) low in extended positions. We compared the data to those of GRA and ST to test (3) if percentages of peak force produced in flexed positions are different. During muscle lengthening surgery of 8 CP patients (9 years, 4 months; GMFCS levels = II–IV; limbs tested = 13) isometric SM forces were measured from flexion (120°) to full extension (0°). Spastic SM forces were low in flexed knee positions (only 4.2% (3.4%) and 10.7% (9.7%) of peak force at KA = 120° and KA = 90° respectively, indicating less force production compared to the GRA or ST) and high in extended knee positions (even 100% of peak force at KA = 0°). This indicates an absence of strong evidence for a shift of optimal muscle length of SM towards flexion. |
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| Keywords: | Cerebral palsy Spasticity Semimembranosus muscle Muscle force-knee angle characteristics Intraoperative measurements |
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