title: Contributors to fatigue resistance of the hamstrings and quadriceps in cerebral palsy.
abstract: BACKGROUND
  The purpose of this study was to elucidate relationships between quadriceps and hamstrings voluntary muscle fatigue and upper motor lesion impairments in cerebral palsy in order to gain a better understanding of their contribution to the observed fatigue resistance.
  
  
  METHODS
  Seventeen ambulatory subjects with cerebral palsy (mean age: 17.0, SD=4.8 years) were recruited. Quantitative measures of strength, spasticity, cocontraction, and stiffness for both muscle groups were collected on an isokinetic dynamometer and entered in a factor analysis. The resulting factors were used as independent variables in a multiple regression analysis with quadriceps and hamstrings fatigue as dependent variables.
  
  
  RESULTS
  Five independent factors explained 90% of the variance. In order of loadings, higher hamstring cocontraction and spasticity and lower hamstring strength were associated with lower levels of hamstring fatigue. Higher quadriceps cocontraction and lower quadriceps strength were the most predictive of lower levels of quadriceps fatigue.
  
  
  CONCLUSIONS
  Greater motor impairments of the agonist muscle, particularly cocontraction, spasticity, and weakness, were associated with lower rates of muscle fatigue of the same muscle during performance of a voluntary fatigue protocol for the hamstrings and quadriceps. Muscles are highly adaptable; therefore, the results of this study suggest that the observed fatigue resistance may be due to the effect of the primary neural insult on motor unit recruitment and rate modulation or the result of secondary adaptations to spasticity, weakness, or excessive cocontraction.
authors.affiliation: Department of Health Professions, Medical University of South Carolina, 77 President St., MSC 700, Charleston, SC 29425, USA. moreau@musc.edu
authors.forename: Noelle G
authors.initials: NG
authors.lastname: Moreau
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: James P
authors.initials: JP
authors.lastname: Geaghan
authors.forename: Diane L
authors.initials: DL
authors.lastname: Damiano
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D004576:Electromyography / Q000379:methods; D006801:Humans; D009119:Muscle Contraction / Q000502:physiology; D018763:Muscle Fatigue / Q000502:physiology*; D009128:Muscle Spasticity; D053580:Muscle Strength / Q000502:physiology; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000502:physiology; D009132:Muscles / Q000502:physiology* / Q000503:physiopathology; D005082:Physical Exertion; D052097:Quadriceps Muscle / Q000502:physiology* / Q000503:physiopathology