Muscle responses to stretching in children with cerebral palsy
Research type
Research Study
Full title
Muscle responses to stretching in children with cerebral palsy
IRAS ID
177362
Contact name
Barbara Kalkman
Contact email
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Cerebral Palsy (CP) has a prevalence of 1.5-3 out of a 1000 live births, making it the most common neurological disorder among children in Europe (Cans, Dev Med Child Neurol, 2000). The most frequently observed problem in CP is hypertonia, i.e. increased tension in a passively stretched muscle (Tardieu, Neurologique, 1954). Hypertonia can ultimately result in contractures (fixed shortening) (Morrell, Radiographics, 2002). Hypertonia has two components: a neural component caused by spasticity, and a non-neural component caused by alterations in muscle and tendon properties. Stretching therapies are widely used as a non-invasive, conservative treatment for contractures, and potentially it may improve spasticity. Little is known about the exact mechanisms at work during muscle stretching, and outcomes of stretching therapies in children with CP are highly variable (Wiart, Pediatr Phys Ther, 2008). They place significant time and commitment demands on the family, and cause discomfort for the child. Therefore, it is vital to provide families and physiotherapists with scientific evidence on the effects of these therapies. A first step herein is to understand the response of spastic muscles to short and long term stretching so that stretching interventions can be optimised. That is why in this study we will look at muscle structure and spasticity measurements during a single stretch and after an acute bout of stretching exercises. During a single stretch we will measure changes in muscle, fascicle and tendon length using ultrasound. Simultaneously we will quantify spasticity by integrating measures of torque, movement and muscle activation (EMG). We will then perform an acute bout of stretching exercises and repeat the same measurements after that to study the short term effect of these stretches. This research will contribute to our understanding of muscle functioning in children with CP and can lead to improvements in stretching therapies.
REC name
London - Harrow Research Ethics Committee
REC reference
15/LO/0856
Date of REC Opinion
1 Jun 2015
REC opinion
Further Information Favourable Opinion