title: Muscle stiffness and strength and their relation to hand function in children with hemiplegic cerebral palsy.
abstract: This study compared the passive stiffness of wrist flexors and the strength of wrist flexors and extensors in three different wrist positions (30 degrees of flexion, neutral, and 30 degrees of extension) between children with cerebral palsy (CP) and typically developing (TD) comparison children. It also examined associations between these characteristics and manual function in children with CP. Eleven children with spastic hemiplegic CP (six females, five males; mean age 8y 5mo [SD 1y 8mo], range 6-11y) and 11 TD children, matched for age and sex, took part in this study. Passive stiffness of muscles was measured as the torque/angle relation during passive motion. Isometric strength tests were performed and the time needed to complete three tasks based on the Jebsen-Taylor Hand Function Test was recorded. Flexor stiffness was higher in the group with CP. Strength of flexors and extensors in the group with CP was lower with the wrist extended. No difference among test positions was found in the TD group. Moderate correlations were observed between manual function and variables related to strength and stiffness of wrist muscles in the group with CP. Children with CP showed muscle alterations coherent with the use of the wrist in flexion. Intervention on these characteristics could have a positive impact on manual function.
authors.affiliation: Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, Brazil. danielavvaz@gmail.com.br
authors.forename: Daniela Virgínia
authors.initials: DV
authors.lastname: Vaz
authors.forename: Marisa
authors.initials: M
authors.lastname: Cotta Mancini
authors.forename: Sérgio T
authors.initials: ST
authors.lastname: Fonseca
authors.forename: Danielle Soares Rocha
authors.initials: DS
authors.lastname: Vieira
authors.forename: Antônio Eustáquio
authors.initials: AE
authors.lastname: de Melo Pertence
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D004185:Disability Evaluation; D019988:Children with Disabilities; D005260:Female; D006225:Hand / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D009048:Motor Skills / Q000502:physiology*; D009068:Movement / Q000502:physiology; D009127:Muscle Rigidity; D009128:Muscle Spasticity; D018908:Muscle Weakness; D018482:Muscle, Skeletal / Q000503:physiopathology*; D018583:Pliability; D012016:Reference Values; D012720:Severity of Illness Index; D014953:Wrist / Q000503:physiopathology*; D014955:Wrist Joint / Q000503:physiopathology