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    Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy

    Access Status
    Fulltext not available
    Authors
    Barber, L.
    Carty, C.
    Modenese, L.
    Walsh, J.
    Boyd, Roslyn
    Lichtwark, G.
    Date
    2017
    Type
    Journal Article
    
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    Citation
    Barber, L. and Carty, C. and Modenese, L. and Walsh, J. and Boyd, R. and Lichtwark, G. 2017. Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy. Developmental Medicine and Child Neurology.
    Source Title
    Developmental Medicine and Child Neurology
    DOI
    10.1111/dmcn.13427
    ISSN
    0012-1622
    School
    School of Occupational Therapy and Social Work
    URI
    http://hdl.handle.net/20.500.11937/52061
    Collection
    • Curtin Research Publications
    Abstract

    © 2017 Mac Keith Press.Aim: This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. Method: Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (p<0.05). Results: In the CP group medial gastrocnemius fascicles lengthened during mid-stance gait and remained longer into late-stance compared to the typically developing group (p<0.001). CP medial gastrocnemius fascicles shortened less during stance (1.16mm [SD 1.47mm]) compared to the typically developing group (4.48mm [SD 1.94mm], p<0.001). In the CP group the medial gastrocnemius and soleus MTU and tendon were longer during early- and mid-stance (p<0.001). Ankle power during push-off (p=0.015) and positive work (p<0.002) and net work (p<0.001) were significantly lower in the CP group. Interpretation: Eccentric action of the CP medial gastrocnemius muscle fascicles during mid-stance walking is consistent with reduced volume and neuromuscular control of impaired muscle. Reduced ankle push-off power and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait.

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